https://orcid.org/0000-0001-9797-6920
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Abstract
Background
Eosinophilic Otitis Media (EOM) is a relatively newly defined entity of recurrent and resistant otitis media.
Objective
To perform a systematic review of otologic manifestations, diagnosis and management of eosinophilic otitis media (EOM).
Methods
393 patients diagnosed with EOM of 26 studies met inclusion criteria and were assessed for demographics, otologic manifestations, diagnostic criteria fulfilled, and medical and surgical treatments.
Results
Most common otologic manifestations were hearing loss (65%), otitis media with effusion (16%), tympanic membrane perforation (13%), and otorrhea (13%). 93% had a predominantly eosinophilic middle ear effusion, 95% had asthma, 85% had a highly viscous middle ear effusion, 71% had nasal polyposis, and 58% had resistance to conventional treatment. For treatment, 39% received intratympanic steroid injections, 33% received systemic steroids, 17% received steroid ear drops and 13% received a biological agent. 39% of patients underwent a surgical intervention with 26% receiving functional endoscopic sinus surgery and 18% receiving myringotomy with tube insertion. Success rates were highest with use of intratympanic steroids (45%), systemic steroids (26%), and biological agents (58%).
Conclusion
Intratympanic steroids show the most efficacy in treating EOM, and aggressive optimization of asthma may be beneficial in resolving otologic symptoms. Surgery should be reserved for refractory cases and complications.
Chinese abstract
背景：嗜酸性中耳炎（EOM）是复发性和抗药性中耳炎的相对较新定义的实体。
目的：对嗜酸性中耳炎（EOM）的耳部表现、诊断和治疗进行系统性的回顾。
方法：26项研究中的393例被诊断为EOM的患者符合纳入标准, 并进行了人口统计学、耳科表现、符合诊断标准以及药物和外科治疗方面的评估。
结果：最常见的耳科表现为听力下降（65％）、中耳炎伴积液（16％）、鼓膜穿孔（13％）和耳漏（13％）。 93％主要为嗜酸性中耳积液, 95％为哮喘, 85％为高粘度中耳积液, 71％为鼻息肉病, 58％对常规治疗有抵抗力。对于治疗, 39％接受鼓膜内类固醇注射, 33％接受全身性类固醇, 17％接受类固醇滴耳剂, 13％接受生物制剂。 39％的患者接受了外科手术, 其中26％的患者接受了外科手术功能性鼻内窥镜鼻窦手术, 18％的患者接受了带管插入的开颅手术。成功率最高的是使用鼓膜内类固醇（45％）、全身性类固醇（26％）和生物介体（58％）。
结论：鼓膜内类固醇对EOM的治疗效果最好, 积极优化哮喘可能有助于解决耳科症状。手术应留给难治性病例和并发症。
Disclosure statement
No potential conflict of interest was reported by the author(s).
Correction Statement
This article has been republished with minor changes. These changes do not impact the academic content of the article.