Eosinophilic chronic rhinosinusitis (ECRS) is a Type 2 inflammatory disease that manifests as chronic inflammation of the paranasal sinus. IL-4/IL-13 receptor monoclonal antibodies (dupilumab) to suppress Type 2 inflammation have become a good treatment option for patients who are refractory to surgery. Most patients respond normally, although significant side effects such as eosinophilic pneumonia may occur, requiring discontinuation of dupilumab. Here, we present a case in which dupilumab administration caused a side-effect of eosinophilic pneumonia. A 65-year-old woman presented with nasal obstruction and olfactory dysfunction due to a nasal polyp. Her symptoms temporarily improved with dupilumab; however, dupilumab was discontinued due to eosinophilic pneumonia. Discontinuation of dupilumab resulted in the rapid resolution of eosinophilic pneumonia and reappearance of nasal polyps. We, therefore, resumed dupilumab treatment in combination with low-dose steroids; eosinophilic pneumonia did not flare up, and the nasal polyps shrank steadily. There is no established treatment strategy in cases where a side effect of eosinophilic pneumonia arises while treating ECRS with dupilumab. Based on the described case, we recommend that a combination of a low-dose steroids and dupilumab be considered as a treatment option to counter the side-effect of eosinophilic pneumonia induced by dupilumab alone.

Objective Endoscopic hydro-mastoidectomy, in which mastoidectomy is performed underwater, can be employed during transcanal endoscopic ear surgery for cholesteatoma removal. It was hypothesised that endoscopic hydro-mastoidectomy might take less time than endoscopic non-underwater mastoidectomy because the endoscope does not need to be removed for cleaning. Methods This study compared the mastoidectomy and total operative durations between the endoscopic hydro-mastoidectomy (n = 25) and endoscopic non-underwater drilling (control, n = 8) groups. Moreover, it compared the size of resected areas of the external auditory canal between the two groups. Results The mastoidectomy time of the endoscopic hydro-mastoidectomy group was significantly shorter than that of the control group (p < 0.01). The total operative time did not differ significantly between the endoscopic hydro-mastoidectomy and control groups (p = 0.17). The resected area was significantly larger in the endoscopic hydro-mastoidectomy group than in the control group (p < 0.05). Conclusion Endoscopic hydro-mastoidectomy enables more extensive bone resection within a shorter period.

Hyperbaric oxygen therapy is one of the therapeutic modalities used for patients with acute sensorineural hearing loss, to increase the amount of dissolved oxygen in the blood and alleviating injuries. As our hospital has the facility for hyperbaric oxygen therapy, we use it, along with corticosteroid therapy, for the treatment of acute sensorineural hearing loss. We examined the effectiveness and complications of hyperbaric oxygen therapy by reviewing the data of 239 cases of sudden deafness treated by this modality.Complications of hyperbaric oxygen therapy occurred in 61 of the 239(25.5%)cases. The incidence rates of earache without otitis media, reddening of the tympanic membrane, and otitis media with effusion were 13.8%, 5.9%, and 4.6%, respectively. In 8.4% cases, it was necessary to discontinue the hyperbaric oxygen therapy because of the occurrence of complications ; however, with appropriate management, therapy for 10 days could eventually be completed in more than half of these cases.An adequate understanding of the principles and complications, as well as of the handling of complications of hyperbaric oxygen therapy, can make the treatment more effective in patients with deafness of sudden onset.