한국인에서 호산구성 중이염의 청력학적 및 임상적 고찰
Audiological and Clinical Finding of Eosinophilic Otitis Media in Korea
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초록
Background and Objectives Eosinophilic otitis media (EOM) is characterized by the presence of a highly viscous effusion containing eosinophils. It mainly occurs in patients with bronchial asthma, nasal polyps and is resistant to conventional treatments for otitis media. In these patients, steroid is very effective in controlling the disease. However, the major complication is sensorineural hearing loss, especially at high frequencies, which may occur despite steroid therapy. Subjects and Method Here we report 10 cases of EOM at Seoul National University Hospital. Clinical courses and characteristics of the patients were analyzed. We compared the hearing deterioration and other clinical variables between EOM patients and age-matched non-EOM chronic otitis media patients. Results All cases had viscous effusion and 9 cases were associated with asthma and nasal polyps. All patients had a decreased hearing in high frequency range compared to the age matched controls. The average bone conduction threshold difference at 2 kHz, 4 kHz was 22.4dB HL and 42.5 dB HL, respectively. Among the patients, one showed profound sensorineural hearing loss bilaterally after the onset of EOM and received cochlear implantation. The open set sentence score was 82% 6 months after cochlear implantation. Most of the cases were resistant to conventional treatments for otitis media, such as administration of antibiotic agents,ventilation tube insertion or mastoidectomy. However, cases that were given steroid treatment had improvement in ear symptoms. Conclusion Since EOM patients show deterioration of hearing, it is important to properly diagnose EOM, start adequate treatment and explain to patients that the disease may last for a long period and progressive hearing loss may occur.
Abstract
Background and Objectives Eosinophilic otitis media (EOM) is characterized by the presence of a highly viscous effusion containing eosinophils. It mainly occurs in patients with bronchial asthma, nasal polyps and is resistant to conventional treatments for otitis media. In these patients, steroid is very effective in controlling the disease. However, the major complication is sensorineural hearing loss, especially at high frequencies, which may occur despite steroid therapy. Subjects and Method Here we report 10 cases of EOM at Seoul National University Hospital. Clinical courses and characteristics of the patients were analyzed. We compared the hearing deterioration and other clinical variables between EOM patients and age-matched non-EOM chronic otitis media patients. Results All cases had viscous effusion and 9 cases were associated with asthma and nasal polyps. All patients had a decreased hearing in high frequency range compared to the age matched controls. The average bone conduction threshold difference at 2 kHz, 4 kHz was 22.4dB HL and 42.5 dB HL, respectively. Among the patients, one showed profound sensorineural hearing loss bilaterally after the onset of EOM and received cochlear implantation. The open set sentence score was 82% 6 months after cochlear implantation. Most of the cases were resistant to conventional treatments for otitis media, such as administration of antibiotic agents,ventilation tube insertion or mastoidectomy. However, cases that were given steroid treatment had improvement in ear symptoms. Conclusion Since EOM patients show deterioration of hearing, it is important to properly diagnose EOM, start adequate treatment and explain to patients that the disease may last for a long period and progressive hearing loss may occur.
참고문헌 (19)
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