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Published on: January 21, 2018
The links between allergy and otitis media with effusion
1Department of Otolaryngology, McGill University, Montreal, Canada. ted.tewfik@mcgill.ca
Summary
Allergic inflammation is present in middle ear effusions, particularly in atopic children. Early screening for allergic rhinitis in children with otitis media with effusion may improve treatment outcomes.
Area of Science:
- Immunology
- Otolaryngology
- Allergy
Background:
- Otitis media with effusion (OME) is a common childhood condition.
- The role of allergic inflammation in OME pathogenesis is increasingly recognized.
Purpose of the Study:
- To review evidence linking allergic inflammation to middle ear effusion.
- To discuss diagnostic challenges and treatment failures in managing allergy-related OME.
- To provide a rationale for future research on allergic inflammation and OME.
Main Methods:
- Review of existing experimental and clinical data.
- Analysis of cellular and cytokine profiles in middle ear effusions and adenoid tissue.
Main Results:
- Atopic children with OME exhibit elevated eosinophils, T lymphocytes, and specific cytokines (interleukin-4, interleukin-5) compared to nonatopic children.
- T-helper 2 cells and associated cytokines are found in both middle ear effusions and adenoid tissue of atopic children.
- A strong correlation exists between middle ear allergic reactions and upper airway inflammation.
Conclusions:
- Current treatment paradigms for OME may need revision based on allergic and nonallergic inflammatory influences.
- Screening all children with OME for allergic rhinitis is recommended.
- Tailored management strategies for OME patients with allergic inflammation are warranted.
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