PMC7322358_01
Intranasal endoscope findings prior to benralizumab treatment (A) and 4 months after benralizumab treatment (B).
gr1.jpg
PMC7322358_01_gr1.jpg
fig1
At admission to our department, nasal endoscopy findings showed large polyps in the bilateral middle nasal meatus (Fig. 1A), while otoscopic findings revealed bilateral effusion in the tympanic cavity. Four months after the initiation of benralizumab treatment, nasal endoscopy indicated a remarkable reduction in the size of bilateral nasal polyps and improvement of nasal obstruction (Fig. 1B).
Nasal computed tomography (CT) images. (A) CT scan prior to benralizumab treatment showed a soft-tissue density shadow extending from the maxillary sinus to ethmoid sinus. (B) CT scan at 4 months after benralizumab treatment showed that the soft-tissue density shadow decreased in size, both in the maxillary sinus and ethmoid sinus.
gr2.jpg
PMC7322358_01_gr2.jpg
fig2
We also observed dominant soft-tissue shadows, in the ethmoid sinus (Fig. 2A) and tympanic cavity in sinus and temporal CT scans, respectively. Sinus CT scans showed that the soft-tissue density shadows in the bilateral ethmoid sinus and maxillary sinus decreased in size (Fig. 2B).
Otoscopic findings at 2 months (A) and 5 months (B) after benralizumab treatment.
gr3.jpg
PMC7322358_01_gr3.jpg
fig3
Otoscopic findings revealed bilateral effusion in the tympanic cavity (Fig. 3A). Myringotomy was performed in both ears (Fig. 3A), and a tympanostomy tube was inserted in the left tympanic membrane to treat highly viscous middle ear effusion (MEE) in the tympanic cavity. One month later, otoscopy revealed the absence of bilateral middle ear effusion (Fig. 3B), and the hearing impairment had improved (Fig. 4B).
Pure tone audiometry results at 2 months (A) and 5 months (B) after benralizumab treatment. The air-bone gap reduced in size in both ears.
gr4.jpg
PMC7322358_01_gr4.jpg
fig4
A pure tone audiogram showed 35.0 dB (right) and 40.0 dB (left) and suggested mixed hearing loss (average of 500, 1000, 2000, and 4000 Hz) (Fig. 4A).