In some adult patients suffering from severe bronchial asthma, or aspirin-induced asthma, otitis media occurring in adulthood is very difficult to control. It has to be discriminated, because it is sometimes complicated with sensorineural hearing loss and surgical treatment is rarely effective. In summary the following characteristics were noted : 1) All the patients suffered from severe bronchial asthma the onset of which occurred in adulthood, or aspirin-induced asthma, several years prior to the onset of otitis media. 2) Nasal polyps and chronic sinusitis frequently occurred and heavy infiltration of eosinophils into the polyps was usually observed. 3) In all the patients, both ears were affected although there was often a difference in severity. These conditions were characterized by a gelatin-like secretion. 4) Tympanoplasty was not effective due to mucosal abnormality. Progression of otitis media in these patients was controllable to a certain degree with steroid therapy. However, advanced condition was difficult to control even with such therapy. These patients suffered from a non-atopic type of allergy. The most characteristic features of the middle ear pathology in these cases were the presence of inflammatory granulation tissue and middle ear effusion both marked by a significant infiltration of eosinophils. In the etiopathology of these conditions, it thought to be that eosinophils play an important role. We therefore think it more appropriate to use the term eosinophilic otitis media to specify the condition of patients with the just described characteristics, especially the presence of a significant infiltration of eosinophils.
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