Vol.100 No.12 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 12 December 2007
Conservative Treatment of Eosinophilic Otitis Media
Toshiro Kawano, Junichi Ishitoya and Ryo Endo
(Yokohama City University Medical Center)
Mamoru Tsukuda
(Yokohama City University Graduate School of Medicine)
Objective: The eosinophilic-otitis-media have characteristic pooling of viscous liquids and granulation tissues in the tympanic cavity. The basic treatment is removal of granulation tissue allowed by an eardrum incision, steroid injection into the tympanic cavity. Therefore, we made eardrum incisions and removed the fluid accumulation and granulation tissues. However, this treatment may induce postoperative eardrum perforation. Therefore, to avoid eardrum perforation after treatment, we injected steroid liquids into tympanic cavity using a 23G fine needle without making an eardrum incision or inserting a tube into the tympanic cavity. Then, we examined the treatment outcomes.
Materials and Methods: We diagnosed 17 cases, 33 ears (male: 2 cases 4 ears, female: 15 cases, 29 ears) (average age: 51.4 years old) as having eosinophilic-otitis-media without perforations based on standard diagnostic criteria. Then, we retrospectively investigated the hearing levels and eardrum perforation after treatment by dividing two groups. One group was treated without making eardrum incisions using a 23G fine needle to inject steroid solution, into the tympanic cavity along with oral steroid administration. The other group was treated by making an eardrum incision or inserting a tube, then, injecting steroid solution into the tympanic cavity along with oral steroid administration.
Result: The group undergoing eardrum incisions had an eardrum perforation rate of 76.4％ (13/17 ears) after treatment. However, the group without eardrum incisions had an eardrum perforation rate of 25.0％ (4/16 ears) after treatment. Regarding hearing improvement, there was not a meaningful hearing improvement after treatment in the group receiving eardrum incisions. However, there was a meaningful postoperative hearing improvement of 500～4000 Hz in the group without eardrum incisions.
Conclusion: We found that treating eosinophilic-otitis-media without eardrum incisions by using a fine needle to inject steroid solution into the tympanic cavity along with oral steroid administration significantly diminished the rate of postoperative perforations.
Key words : conservative treatment, eosinophilic otitis media, steroid