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Nasal Allergy and Otitis Media: A real correlation?

Desiderio Passali1, Giulio C Passali2, Maria Lauriello3

  • 1Università di Siena, Siena, Italy;

Sultan Qaboos University Medical Journal
|February 12, 2014
PubMed

Insights

Persistent allergic rhinitis in children is significantly associated with otitis media with effusion (OME) and delayed mucociliary transport time. Middle ear effusion also showed higher eosinophil cationic protein (ECP) levels in persistent cases.

Area of Science:

  • Pediatric Otolaryngology
  • Allergy and Immunology
  • Pediatric Respiratory Medicine

Background:

  • The link between middle ear pathology and nasal allergies has been a long-standing debate.
  • Otitis media with effusion (OME) is a common pediatric condition, and allergic rhinitis affects a significant portion of children.
  • Understanding the interplay between these conditions is crucial for effective diagnosis and management.

Purpose of the Study:

  • To investigate the relationship between otitis media with effusion (OME) and persistent allergic rhinitis symptoms compared to intermittent rhinitis in children.
  • To evaluate specific clinical and immunological markers associated with OME in children with allergic rhinitis.

Main Methods:

  • A cohort of 100 atopic children aged 5-9 years with otological symptoms underwent comprehensive ear, nose, and throat evaluations.
  • Diagnostic tools included tympanometry, skin prick tests (SPTs) for allergens, mucociliary transport time (MCTt) measurements, and Eustachian tube function tests.
  • Middle ear effusion analysis included eosinophil cationic protein (ECP) levels.

Main Results:

  • Skin prick tests identified sensitization to common allergens like Dermatophagoides pteronyssinus, grass pollen, and Parietaria.
  • A significant proportion of children experienced moderate to severe symptoms, with a notable number having persistent rhinitis.
  • Delayed mucociliary transport time (MCTt) was observed in children with persistent rhinitis (21 ± 2 mins) compared to intermittent rhinitis (16 ± 2 mins) (P <0.01).
  • Middle ear effusion was present in 45 children, and significantly elevated eosinophil cationic protein (ECP) levels were found in middle ear effusions (251 ± 175.2 μg/L) and blood (25.5 ± 16.3 μg/L) (P < 0.001).

Conclusions:

  • A significant association exists between otitis media with effusion (OME), delayed mucociliary transport time, and elevated eosinophil cationic protein (ECP) levels in middle ear effusions of children with persistent allergic rhinitis.
  • These findings suggest that the middle ear mucosa may act as a direct target organ in the pathophysiology of persistent allergic rhinitis in children.
Abstract

Keywords:
ChildrenEustachian TubesGenetic PredispositionItalyNasal AllergyOtitis Media

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