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Middle ear diseases in relation to atopy and nasal metachromatic cells in infancy
K Irander1, M P Borres, B Björkstén
1Department of Otorhinolaryngology, Faculty of Health Sciences, Linköping University, Sweden.
Insights
Infants with atopy, particularly those with asthma, experience more middle ear infections. Early detection of nasal allergic cells indicates a higher risk for middle ear disease in infants.
Area of Science:
- Pediatrics
- Allergology
- Otolaryngology
Background:
- Atopy, a genetic predisposition to allergic diseases, is common in infants.
- Middle ear disease, including otitis media, is a frequent childhood ailment.
- The relationship between atopy and middle ear morbidity requires further investigation.
Purpose of the Study:
- To prospectively examine the association between atopy and middle ear morbidity in infants.
- To identify specific allergic manifestations linked to increased middle ear disease.
- To explore the role of environmental factors like tobacco smoke exposure.
Main Methods:
- A prospective study involving 44 infants with a family history of atopy and 20 controls.
- Atopy signs were assessed at 3, 6, 9, and 18 months.
- Middle ear disease signs were monitored, and nasal metachromatic cells and tobacco smoke exposure were evaluated.
Main Results:
- Atopy developed in 39 infants; 27 had definite signs, 12 probable.
- Infants with respiratory tract allergy had more acute otitis media and longer otitis media with effusion episodes.
- Middle ear disease was more prevalent in infants with detected nasal metachromatic cells.
- Tobacco smoke exposure increased respiratory infections but not middle ear morbidity.
Conclusions:
- Middle ear morbidity is more common in atopic infants, especially those with asthma.
- Early presence of nasal metachromatic cells is associated with increased middle ear infections.
- Atopic infants with respiratory symptoms face a higher burden of middle ear disease.
Abstract:
The relation between middle ear morbidity and atopy was prospectively studied in 44 infants with and 20 without a confirmed family history of atopy. Signs of atopy were recorded at 3, 6, 9 and 18 months of age and signs of middle ear disease were recorded and controlled as needed. Twenty-seven children developed definite signs of atopy, while 12 showed probable signs and 25 remained free from allergic symptoms. The number of episodes of acute otitis media was higher and the duration of episodes of otitis media with effusion were longer in 13 infants with respiratory tract allergy, as compared with 14 allergic children with only skin manifestations and with 25 non-atopic children. Middle ear diseases were more commonly encountered in infants in whom nasal metachromatic cells were detected. Children exposed to tobacco smoke suffered more often from respiratory tract infections but not from increased middle ear morbidity in comparison with non-exposed children. In conclusion, middle ear morbidity during the first 18 months of life is more common in atopic children with asthma than in non-atopic infants and early appearance of nasal metachromatic cells is associated with middle ear infections.