2019 Volume 70 Issue 5 Pages 320-325
Allergic rhinitis (AR), eosinophilic chronic rhinosinusitis (ECRS), and eosinophilic otitis media (EOM) are well-known eosinophilic inflammatory diseases in the otorhinolaryngological area. Several chemical mediators and cytokines released from eosinophils are associated with nasal blockage in the late phase of AR. ECRS is characterized by bilateral lesions with nasal polyps and viscous nasal secretion, and much severer lesions are observed in the ethmoid sinuses compared with the maxillary sinuses. Nasal polyps and mucosal inflammation of ECRS are intractable and recur easily even after performing endoscopic sinus surgery. Th2-type cytokines such as IL-4, IL-5, and IL-13 and periostin induce eosinophilic infiltration, and extracellular trap cell death is thought to contribute to the formation of viscous nasal secretion. EOM is also a refractory disease, characterized by glue middle ear effusion infiltrated with eosinophils, which sometimes causes sensorineural hearing loss. The pathogenesis of EOM is similar to that of ECRS. Since eosinophilic inflammatory diseases are frequently complicated with bronchial asthma, it is important to treat patients with these diseases in cooperation with pulmonologists.
