耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
ISSN-L : 0032-6313
臨床
デュピルマブ導入後にトラフェルミン製剤を用いて鼓膜再生療法を施行した好酸球性中耳炎例
洲崎 勲夫浜崎 泰佑竹内 美緒田中 義人平野 康次郎江川 峻哉嶋根 俊和小林 一女
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2023 年 116 巻 8 号 p. 739-747

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Eosinophilic otitis media (EOM), which is characterized by effusion caused by the accumulation of eosinophils in the middle ear mucosa, is a type of refractory otitis media that is often associated with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Despite the critical need for management of the eosinophilic inflammation of the middle ear and of the comorbid airway diseases using topical and systemic steroids, no well-established treatments exist currently. Dupilumab, an anti-interleukin (IL)-4R alpha monoclonal antibody, has been approved for the treatment of atopic dermatitis, severe asthma, and refractory CRSwNP. This report presents the case of patient with EOM complicated by severe asthma and eosinophilic chronic rhinosinusitis (ECRS), in whom the EOM symptoms improved after dupilumab administration. After the resolution of EOM was clinically confirmed, regenerative treatment was administered using a trafermin kit (Retympa®) for the tympanic membrane perforation caused by the EOM. At the 6-month follow-up, the patient’s hearing level had improved and the tympanic membrane had healed successfully. Thus, optimized therapy for eosinophilic inflammatory diseases including type 2 inflammatory agents, such as IL-4 and -13, may be important to manage the clinical condition of EOM associated with asthma and ECRS.

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