Otitis media with effusion as a marker of the inflammatory process associated to nasal polyposis

Despite the close location of polyps with the Eustachian tube, association between nasal polyposis (NP) and otitis media with effusion (OME) has not been described in the literature. Our retrospective case-control study aimed at assessing the relative risk to develop OME when NP is associated to factors such as asthma, aspirin intolerance (AI), atopy, eosinophil infiltration of polyp tissue, and history of surgical treatment (HST). We compared the charts of 25 NP patients presenting symptomatic OME with 50 NP patients without OME. All the charts contained validated data about OME, asthma, AI, atopy, eosinophil count in polyp tissue, and HST. Our study showed that the risk to develop OME in NP patients is five times higher in patients presenting aspirin triad (NP + asthma + AI) (OR = 5.6, p = 0.009) and three times higher in HST patients (OR = 3.5, p = 0.03), than in isolated NP patients. A linear trend exists between the different degrees of respiratory disease and the risk of OME (p = 0.01). Our data suggest that the development of OME could be considered as another marker of severity of the inflammatory disease leading to NP, asthma and AI. Better characterisation of NP patients with OME could allow is to define more accurately the nature, type and severity of the underlying inflammatory process.