2020 Volume 113 Issue 7 Pages 405-411
Eosinophilic otitis media (EOM) and eosinophilic chronic rhinosinusitis (ECRS) are both intractable upper airway diseases characterized by infiltration of numerous eosinophils. Both EOM and ECRS show high rates of comorbidity with asthma, and are considered to have a “one airway, one disease” relationship with asthma. Here, we summarize our current knowledge regarding the characteristics of EOM/ECRS, their relationships with asthma, and the efficacy of treatments for EOM/ECRS. The greater the severity of asthma, the more severe the EOM/ECRS. Appropriate strengthening of asthma inhalational therapy leads to improvement of comorbid EOM/ECRS. In addition, mild EOM responds to intratympanic infusion of a topical steroid, such as triamcinolone acetonide (TA), whereas moderate EOM requires a systemic steroid together with TA; severe EOM is associated with the formation of granulation tissue that requires surgical removal. Endoscopic sinus surgery is effective for the treatment of ECRS. To prevent recurrence of ECRS, medications such as montelukast, an anti-leukotriene agent, in addition to steroid treatment are necessary in many cases. Recently, the effectiveness of molecular-targeted drugs has been reported, but more data need to be accumulated.
