Diagnostic criteria of eosinophilic otitis media, a newly recognized middle ear disease
Diagnostic criteria of eosinophilic otitis media, a newly recognized middle ear disease
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DOI：
10.1016/j.anl.2010.11.016
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发表时间：
2011-08-01
影响因子：
1.7
通讯作者：
Nonaka, Manabu
中科院分区：
文献类型：
--
作者：
Iino, Yukiko;Tomioka-Matsutani, Sachiko;Nonaka, Manabu
目的：嗜酸性中耳炎(EOM)是新近发现的一种难治性中耳疾病，以中耳渗出液和中耳粘膜中嗜酸性粒细胞聚集为特征。由于EOM患者表现为逐渐或突然的听力恶化，因此正确诊断EOM并开始适当的治疗非常重要。目的：探讨EOM的临床危险因素，建立EOM的诊断标准。患者和方法：回顾138例EOM患者和134例年龄匹配的EOM患者，并以渗出性中耳炎和慢性中耳炎为对照。结果：双侧中耳炎、中耳积液粘滞性、中耳肉芽组织形成、对中耳炎的治疗反应、骨传导听力下降，以及与其他疾病如支气管哮喘、慢性鼻窦炎、鼻息肉和变应性鼻炎相关的发生率均较高。结果：与支气管哮喘、中耳炎常规治疗抵抗(232.2)、中耳粘液(201.6)、鼻息肉(42.17)、慢性鼻窦炎(26.49)、双侧性(12.93)和肉芽组织形成(12.62)。两项或两项以上阳性的EOM患者占98.55%。结论：以渗出性中耳炎或以嗜酸性粒细胞为主的渗出性中耳炎为主要标准，且在四项中有两项或两项以上(次要标准)的患者可诊断为EOM。有耳部症状的患者应使用建议的诊断标准对EOM进行正确的诊断，然后才能接受适当的治疗，从而防止听力恶化和生活质量下降。(C)2011年，爱思唯尔爱尔兰有限公司出版。
Objective: Eosinophilic otitis media (EOM) is a newly recognized intractable middle ear disease, characterised by the accumulation of eosinophils in middle ear effusion and middle ear mucosa. Since EOM patients show gradual or sudden deterioration of hearing, it is important to properly diagnose EOM and to start adequate treatment for EOM. We aimed to investigate the clinical risk factors of EOM and to establish the diagnostic criteria of EOM.Patients and methods: We reviewed 138 patients with EOM and 134 age-matched patients with the common type of otitis media with effusion or chronic otitis media as controls. We analyzed the incidence of the following clinical variables in both groups: bilaterality of otitis media, viscosity of middle ear effusion, formation of granulation tissue in the middle ear, response to the treatment for otitis media, deterioration of bone conduction hearing level, and association with other diseases such as bronchial asthma, chronic rhinosinusitis, nasal polyposis, and allergic rhinitis.Results: A high odds ratio was obtained from an association with bronchial asthma (584.5), resistance to conventional treatment for otitis media (232.2), viscous middle ear effusion (201.6), association with nasal polyposis (42.17), association with chronic rhinosinusitis (26.49), bilaterality (12.93), and granulation tissue formation (12.62). The percentage of patients with EOM who were positive for two or more among the highest four items was 98.55%.Conclusion: A patient who shows otitis media with effusion or chronic otitis media with eosinophil-dominant effusion (major criterion) and with two or more among the highest four items (minor criteria), can be diagnosed as having EOM. Patients with ear symptoms should have the proper diagnosis of EOM using the proposed diagnostic criteria, and then can receive adequate treatment, resulting in prevention of deterioration of hearing and quality of life. (C) 2011 Published by Elsevier Ireland Ltd.