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An Unusual Case of Eosinophilic Chronic Rhinosinusitis With Concurrent Eosinophilic Otitis Media: Limited Responsiveness to Multiple Antibody Therapies and Subsequent Cochlear Implantation.
Urabe, Kosuke; Ohta, Yumi; Fujii, Soichiro; Tsuda, Takeshi; Inohara, Hidenori.
Afiliación
  • Urabe K; Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Faculty of Medicine, Osaka University, Suita, JPN.
  • Ohta Y; Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Faculty of Medicine, Osaka University, Suita, JPN.
  • Fujii S; Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Faculty of Medicine, Osaka University, Suita, JPN.
  • Tsuda T; Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Faculty of Medicine, Osaka University, Suita, JPN.
  • Inohara H; Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Faculty of Medicine, Osaka University, Suita, JPN.
Cureus ; 15(11): e49033, 2023 Nov.
Article en En | MEDLINE | ID: mdl-38116349
ABSTRACT
Eosinophilic chronic rhinosinusitis (ECRS) and eosinophilic otitis media (EOM) are debilitating inflammatory conditions that affect the paranasal sinuses and middle ear, respectively, and are characterized by eosinophilic infiltration. This study describes a rare and intricate case of a 65-year-old male patient concurrently afflicted with ECRS, EOM, and bronchial asthma. Despite the systematic administration of corticosteroids and various antibody drugs, the patient's condition remained unimproved, necessitating a cochlear implant for EOM, which is seldom an aggressive intervention. The patient had a history of symptoms dating back to 2005, with notable exacerbations and treatment resistance over the years. Multiple antibody drugs, including anti-IgE, anti-IL-5, and anti-IL-4α antibodies, failed to ameliorate the patient's condition, presenting a significant clinical challenge. Pathological examination revealed marked eosinophilic infiltration and severe fibrosis, suggesting a possible mechanism underlying the poor response to antibody therapy. Cochlear implantation significantly enhanced the patient's communicative abilities. This case highlights the limitations of the current antibody drugs in managing severely intertwined cases of ECRS, EOM, and bronchial asthma, highlighting the need for novel therapeutic strategies. This case also propounds cochlear implantation as an efficacious intervention for refractory EOM with severe sensorineural hearing impairment, extending the spectrum of treatment modalities for such challenging scenarios. This singular case contributes to the growing body of evidence regarding the management of ECRS and EOM, especially against the backdrop of treatment resistance, and can aid clinicians in identifying and navigating similar complex cases in clinical practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cureus Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos