Role of food allergy in serous otitis media

The relationship between IgE-mediated hypersensitivity and recurrent serous otitis media has not been completely established.

The purpose of the present study was to examine the prevalence of food allergy in patients with recurrent serous otitis media.

A total of 104 unselected patients (age range 1.5 to 9 years, mean 4.6 years) with recurrent serous otitis media were evaluated for food allergy by means of skin prick testing, specific IgE tests, and food challenge. Patients who were allergic to food(s) underwent an exclusion diet of the specific offending food(s) for a period of 16 weeks. A non-double blinded food challenge was performed with the suspected offending food(s). Their middle ear effusion was monitored and assessed by tympanometry (Welch Allyn Model 23600) during the pre-elimination, elimination and challenge diet phases.

There was a significant statistical association, by chi-square analysis, between food allergy and recurrent serous otitis media in 81/104 patients (78%). The elimination diet led to a significant amelioration of serous otitis media in 70/81 (86%) patients as assessed by clinical evaluation and tympanometry. The challenge diet with the suspected offending food(s) provoked a recurrence of serous otitis media in 66/70 patients (94%).

The possibility of food allergy should be considered in all pediatric patients with recurrent serous otitis media and a diligent search for the putative food allergen made for proper diagnostic and therapeutic intervention.