Eosinophilic otitis media diagnosis using flow cytometric immunophenotyping

Abstract

Objectives: (1) To assess the ability of flow cytometric immunophenotyping to detect and quantitate eosinophils in patients with eosinophilic otitis media (EOM). (2) to evaluate the association of EOM to bronchial asthma.

Methods: Twenty-one patients with chronic otorrhea or middle ear effusion (MEE) were included in this prospective cohort study. Group I composed of 10 patients (14 ears) and associated to bronchial asthma. Group II included 11 patients (11 ears) without bronchial asthma. Samples of MEE were sent for flow cytometric analysis at initial presentation. Patients with positive eosinophils on flow cytometric immunophenotyping were analyzed after one-month course of dexamethasone eardrops.

Results: EOM was diagnosed in all patients of group I and in three patients of group II. The mean eosinophils percentage was 43.5% and 14.2% for group I and group II, respectively (p = .006). Those patients showed a significant response to dexamethasone eardrops, both on clinical examination and on flow cytometric analysis with a decrease in eosinophil levels post-treatment. However, this improvement was temporary and symptoms recurred after treatment cessation. Bronchial asthma was not associated to all patients with EOM.

Conclusion: Diagnosis of EOM remained mostly clinical; flow cytometry immunophenotyping of MEE may be helpful as an additional tool in diagnosis and monitoring the response to treatment, particularly in non-asthmatic patients.

Chinese abstract

目的：1）评估流式细胞仪免疫表型分析对嗜酸粒细胞性中耳炎（EOM）患者进行检测和定量嗜酸性粒细胞的能力。 2）评估EOM与支气管哮喘的关系。

方法：该前瞻性队列研究包括21例慢性耳漏或中耳积液（MEE）患者。 I组由10名有支气管哮喘的患者（14耳）组成。 II组包括11名（11耳）无支气管哮喘的患者。MEE样本一呈现就进行了流式细胞仪分析。在1个月的地塞米松耳滴疗程后, 对流式细胞仪免疫表型阳性嗜酸性粒细胞患者进行了分析。

结果：I组所有患者和II组3例患者均诊断出EOM。 I组和II组平均嗜酸性粒细胞百分比分别为43.5％和14.2％（p = .006）。那些患者在临床检查和流式细胞仪分析时都表现出对地塞米松耳滴的明显反应, 在治疗后嗜酸性粒细胞水平降低。然而, 这种改善是暂时的, 治疗停止后症状又复发了。支气管哮喘与所有EOM患者无关。

结论：EOM诊断主要为临床的; MEE的流式细胞术免疫表型分析作为诊断和监测治疗反应的另一工具还是有用的, 对非哮喘患者特别如此。

Keywords:

• Eosinophilic otitis media
• flow cytometry
• immunophenotyping
• middle ear effusion

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

No funding received for this work from any of the following organizations: NIH, Welcome Trust, HHMI or other.