Eosinophilic otitis media and comorbid asthma

Abstract

Purpose of review Eosinophilic otitis media (EOM) is an intractable otitis media characterized by numerous eosinophils infiltrating the middle ear cavity, which is part of the upper airway. EOM shows a high rate of comorbidity with asthma. They are considered to have a ‘one airway, one disease’ relationship. Here, we summarize our current knowledge regarding the characteristics of EOM, EOM's relationship with asthma and the efficacy of optimal treatments for EOM. Recent findings The greater the severity of asthma, the more pronounced the development of EOM. Asthma control is usually inadequate in asthmatics who develop EOM, and appropriate strengthening of asthma inhalation therapy leads to improvement in the EOM. EOM severity can be divided into mild, moderate, and severe. Intratympanic infusion therapy using a topical steroid such as triamcinolone acetone is effective for mild EOM, whereas moderate EOM requires a systemic steroid in addition to triamcinolone acetone, and severe EOM forms granulation tissue that requires surgical removal. Recently, the effectiveness of molecularly targeted drugs is being reported, but more data need to be accumulated. Summary EOM and asthma are closely related. Optimal asthma treatment is important for treating EOM. Treatments commensurate with the severity of EOM are being developed.

Is Omalizumab Related to Ear and Labyrinth Disorders? A Disproportionality Analysis Based on a Global Pharmacovigilance Database

“…Although omalizumab safety was generally considered tolerable, as reported in clinical trials [ 15 , 16 ], a RCT [ 16 ] and a report [ 18 ] demonstrated the onset of ear disorders after omalizumab use in patients with asthma. This study found symptoms of EOM, such as deafness, otorrhea, and tympanic membrane perforation, in omalizumab AE reports, consistent with previous studies [ 20 , 21 , 33 , 34 ]. In addition, increased eosinophil effects were detected following omalizumab treatment.…”

“…Other studies reported that eosinophilic comorbidities could occur during omalizumab treatment in the ear, nose, and throat (ENT), particularly eosinophilic otitis media (EOM) [ 18 ]. EOM showed a high rate of comorbidity with asthma and is characterized by discharge with a high concentration of eosinophils and high viscosity in the middle ear cavity [ 19 , 20 ]. Only patients with moderate or severe persistent asthma showed EOM onset, with frequent incidences occurring in patients with severe asthma [ 20 ].…”

“…EOM showed a high rate of comorbidity with asthma and is characterized by discharge with a high concentration of eosinophils and high viscosity in the middle ear cavity [ 19 , 20 ]. Only patients with moderate or severe persistent asthma showed EOM onset, with frequent incidences occurring in patients with severe asthma [ 20 ]. For EOM patients, systemic or topical steroid administration is considered the most effective option for asthma [ 21 ].…”

Association Between Pneumonia and Chronic Otitis Media: A Nested Case-Control Study Using a National Health Screening Cohort

“…However, studies on the relationship between respiratory tract diseases and otitis media have mainly been conducted targeting upper respiratory tract (URT) diseases such as bronchitis and asthma, eosinophilic otitis media, and otitis with effusion in children (Kim et al, 2021, Seo et al, 2020, Wine and Alper, 2012.…”

Morphological and pathological changes of Eustachian tube mucosa in an animal model of eosinophilic otitis media

“… 3 , 4 , 5 Epidemiological studies have found that OME is more likely to be a comprehensive manifestation of atopic allergic diseases such as allergic rhinitis, eczema, and asthma. 6 , 7 , 8 , 9 , 10 , 11 , 12 Accumulating clinical observations suggest that some patients with OME do not exhibit acute inflammation symptoms, while others present the symptoms even after the acute phase has passed. 13 , 14 , 15 , 16 , 17 , 18 , 19 There have been many reports on patients with intractable OME or chronic otitis media associated with bronchial asthma and/or allergic rhinitis.…”