[Eosinophilic otitis media].
BACKGROUND
Eosinophilic otitis media (EOM) is a rare middle ear disease that may closely resemble therapy-resistant otitis media with effusion (OME). The diagnosis is made if eosinophil-rich fluid is present with two or more of the following minor criteria: (a) history of nasal polyps or, (b) bronchial asthma, with (c) viscous fluid in the middle-ear, or (d) conventional otitis media treatment has no effect.


METHODS
A 70-year-old male with a history of the ASA triad (bronchial asthma, nasal/ethmoidal polyposis and aspirin intolerance) presented with progressive mixed hearing loss. Otoscopy showed bilateral otitis media with effusion (OME). Conventional treatment of this had no effect. Myringotomy resulted in the evacuation of highly viscous middle-ear effusion containing abundant eosinophils. After treatment with oral corticosteroids his symptoms improved considerably. Following later optimisation of his asthma treatment, corticosteroid treatment was stopped and his hearing remained stable.


CONCLUSIONS
The adequate recognition and treatment of EOM will result in the prevention of permanent hearing loss.
Maastricht Universitair Medisch Centrum, afd. Keel-, Neus- en Oorheelkunde, Maastricht.
Monique A M
MA
de Jong
L O M J Otto
LO
Smithuis
Robert J
RJ
Stokroos
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D001249:Asthma / Q000150:complications*; D004804:Eosinophils; D034381:Hearing Loss / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
D000305:Adrenal Cortex Hormones