Asia Pac Allergy.  2018 Jan;8(1):e5. 10.5415/apallergy.2018.8.e5.

Optimal control of asthma improved eosinophilic otitis media

Affiliations
  • 1Department of Otolaryngology, Tokyo Women's Medical University, Tokyo 162-8666, Japan. nonaka-m@twmu.ac.jp
  • 2Department of Pediatrics, Nippon Medical School, Tokyo 113-0022, Japan.
  • 3First Department of Medicine, Tokyo Women's Medical University, Tokyo 162-8666, Japan.

Abstract

BACKGROUND
Eosinophilic otitis media (EOM) is often associated with comorbid asthma. The middle ear cavity is part of the upper airway. Therefore, EOM and asthma can be considered to be a crucial part of the "one airway, one disease" phenomenon. Based on the concept of one airway, one disease in the context of allergic rhinitis and asthma, optimal level of inhalation therapy for better asthma control leads to improvement in allergic rhinitis.
OBJECTIVE
We conducted a pilot study to determine whether appropriate strengthening of inhalation therapy for asthma is effective for EOM.
METHODS
Fifteen patients with EOM and comorbid asthma were enrolled in this study. Eight patients were randomly selected and administered appropriately strengthened inhalation therapy for asthma (strengthened group). The effect of the therapy on EOM was assessed by comparing a questionnaire for ear symptoms, clinical characteristic score, pure tone audiometry, blood tests and temporal bone computed tomography (CT) examination before and after the therapy. Seven other EOM + asthma patients without the above mentioned therapy were included as controls.
RESULTS
In the strengthened group, the score of ear symptoms, clinical characteristics score, peripheral blood eosinophil count, CT score, and air conduction hearing level improved significantly after strengthening the inhalation therapy, but not in the control group. The lung function tests (forced vital capacity [%predicted], forced expiratory volume in 1 second [FEV₁] [L], and FEV₁ [%predicted]) significantly increased in the strengthened group after the therapy, but not in the control group.
CONCLUSION
In this study we demonstrated that EOM improved along with improved lung function when appropriately optimal inhalation therapy was implemented in patients with EOM and asthma. Administration of optimizing therapy for asthma might be effective for concomitant EOM.

Keyword

Eosinophilic otitis media; One airway, one disease; Optimized asthma treatment; Asthma

MeSH Terms

Asthma*
Audiometry
Ear
Ear, Middle
Eosinophils*
Forced Expiratory Volume
Hearing
Hematologic Tests
Humans
Lung
Otitis Media*
Otitis*
Pilot Projects
Respiratory Function Tests
Respiratory Therapy
Rhinitis, Allergic
Temporal Bone
Vital Capacity
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