Persistent otorrhea in a 48 years old patient. And now?

Introduction:

Eosinophilic otitis media (EOM) is characterized as a refractory otitis media with persistent high-viscosity tympanic effusion with eosinophilia that does not respond to conventional therapies such as local or systemic antibiotics or tympanic paracentesis. Often nasal polyposis or asthma are concomitant in the literature.

Methods/Case report:

48-year-old female patient after prior tympanoplasty with mastoidectomy left, 4 paracentesis/tympanic drainage left and 2 sinus surgeries. Despite successful ear surgery and antibiotic therapies (local/oral), the highly viscous otorrhea persisted on the left side. She also suffered from asthma. The examination revealed a dull eardrum with a lying T-tube and a highly viscous secretion on the left, nasal endoscopy showed moderate polyposis on both sides. Laboratory: serum eosinophilia of 6% (+), total IgE of 81 IU/l (=) without specific allergies. There was no evidence of a Wegener granulomatosis or a cholesteatoma in differential diagnosis. After diagnosis of an EOM on the left side, a local cortisone therapy with triamcinolone acetonide (40 mg/ml) was initiated and applied every 4 weeks via the T-tube.

Results:

The otorrhea was no longer detectable in the monthly findings over an observation period of 4 months.

Conclusion:

In patients with findings as mentioned above should be thought of an EOM. Transtympanic triamcinolone injections are an effective therapy option.

Publication History

Publication Date:
12 June 2019 (online)