Otolaryngology Case Reports · Published 2026-06-28 · DOI 10.1016/j.xocr.2026.100759
Ángela María Campos Mahecha, Gency Burbano-Bolaños, Augusto Peñaranda, Daniel Peñaranda, María J. Erazo Muñoz, Camilo Vega Useche
Eosinophilic otitis media (EOM) is a rare and difficult-to-treat inflammatory middle ear disease frequently associated with type 2 inflammatory comorbidities, particularly asthma and chronic rhinosinusitis with nasal polyposis. We report the long-term clinical, radiological, audiological, immunological, and histopathological follow-up of a patient with refractory EOM who received dupilumab for severe chronic rhinosinusitis with nasal polyposis and subsequently underwent staged otologic surgery. A 57-year-old man presented with persistent bilateral otorrhea and progressive hearing loss in the setting of longstanding asthma and chronic rhinosinusitis with nasal polyposis. Previous treatment, including left mastoidectomy and bilateral tympanostomy with ventilation tubes, had failed to achieve sustained symptom control. Baseline assessment showed moderate bilateral mixed hearing loss, elevated total IgE, peripheral eosinophilia, obstructive spirometry, and bilateral inflammatory soft tissue involvement of the middle ear and mastoid cavities on computed tomography. Dupilumab was initiated primarily for chronic rhinosinusitis with nasal polyposis and type 2 inflammation, rather than as a direct indication for EOM. During follow-up, the patient showed progressive reduction in otorrhea and middle ear inflammation, improvement in otoendoscopic findings, closure of the air-bone gap, improved pure-tone average thresholds, reduced inflammatory soft tissue density on imaging, and improvement in sinonasal endoscopic findings. Histopathological evaluation supported eosinophil-predominant inflammation. No adverse events related to dupilumab were observed. This case suggests that dupilumab may provide additional middle ear benefit when used for approved type 2 inflammatory indications in selected patients with refractory EOM and associated type 2 inflammatory disease. Further studies are needed to define indications, timing, and long-term effectiveness.
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Mahecha, Á., Burbano-Bolaños, G., Peñaranda, A., et al. (2026). Dupilumab and staged otologic surgery in refractory eosinophilic otitis media associated with chronic rhinosinusitis with nasal polyposis: a case report. Otolaryngology Case Reports. https://doi.org/10.1016/j.xocr.2026.100759