Abstract
We herein report the first case of allergic otitis media identified by an immunological examination of both otorrhea and serum. A 44-year-old female had an 18 month history of bilateral continuous otorrhea and hearing loss. These symptoms worsened from February to April when her nasal allergy to Japanese cedar pollen (Cryptomeria japonica) appeared. Her tympanic membranes were centrally perforated with a remarkable amount of viscous secretion containing many eosinophils and the promontory mucosa was also considerably swollen. An immunological examination showed a positive finding for the CAP-RAST score for Japanese cedar pollen, not only in the serum but also in the middle ear secretion. Because these facts demonstrated type I allergy to Japanese cedar pollen due to the existence of IgE antibody in the middle ear, she was diagnosed to have a middle ear allergy to Japanese cedar pollen. Combination therapy using anti-allergic drugs and steroids (p. o.), as well as the intratympanic injection of steroids and myringoplasty resulted in a good improvement in the otorrhea symptoms and, as a result, her hearing loss also recovered.
