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Eustachian Tube Function in Patients With Eosinophilic Otitis Media Associated With Bronchial Asthma Evaluated by Sonotubometry
Yukiko Iino, MD, PhD;
Keiko Kakizaki, MD;
Shoji Saruya, MD, PhD;
Hiroaki Katano, MD;
Takashi Komiya, MD;
Kazuoki Kodera, MD, PhD;
Ken Ohta, MD, PhD
Arch Otolaryngol Head Neck Surg. 2006;132:1109-1114.
Objective To determine eustachian tube function in patients with asthma and with or without eosinophilic otitis media (EOM), a new middle ear disease entity with a highly viscous middle ear effusion containing many eosinophils and usually associated with bronchial asthma. One of the most important causes of otitis media (OM) is eustachian tube dysfunction.
Design Retrospective case review.
Setting A referral center.
Patients Twenty patients with EOM and patients with asthma but without OM.
Main Outcome Measures We studied eustachian tube function using sonotubometry and a questionnaire. Sonotubometry was also performed on 13 control patients with chronic otitis media (COM) and 7 normal controls.
Results The tubal opening duration was significantly longer in patients with EOM than in patients with asthma but without OM, controls with COM, and normal controls, indicating the presence of patulous eustachian tubes in patients with EOM. Responses to the questionnaire also supported the presence of patulous eustachian tubes in the patients with EOM.
Conclusions The presence of a patulous eustachian tube may be a major cause of EOM in patients with bronchial asthma. In patients with asthma who have a helper T-cell 2dominant predisposition, a patulous eustachian tube easily allows the entry of antigenic materials into the middle ear, causing eosinophil-dominant inflammation.
Author Affiliations: Departments of Otolaryngology (Drs Iino, Kakizaki, Saruya, Katano, Komiya, and Kodera) and Internal Medicine (Dr Ohta), Teikyo University School of Medicine, Tokyo, Japan.
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