Allergic eustachian tube dysfunction: diagnosis and treatment

The objective of this study was to describe the characteristics and response to specific allergy therapy of patients with clinically significant eustachian tube dysfunction secondary to allergy.

This was a retrospective case review conducted in the setting of a private otologic practice (tertiary referral).

The study population was composed of 151 patients presenting with eustachian tube dysfunction who had evidence of allergy and had undergone allergy testing and treatment. The 105 females and 50 males ranged in age from 2.8 to 84 years (mean 41.8 +/- 17.3).

Interventions used included diagnostic allergy testing (inhalants and food) and treatment with immunotherapy and diet.

The main outcome measures were descriptive characteristics and ratings of fullness, allergy symptoms, and well-being rated as "improved," "no change," or "worse."

All patients had reactivity to inhalants, and 92.3% were positive to one or more foods. Nearly half of the patients (49.4%) had undergone at least one advanced test beyond an audiogram as part of their diagnostic evaluation before referral to a tertiary center for treatment. Forty percent had undergone radiological assessment. Nearly all had used one or more other treatments without success before allergy therapy. The majority were rated as improved on all three symptoms (fullness 70.9%; allergy symptoms 82.8%; and well-being 80.2%). Adherence to the recommended elimination diet was significantly related to outcome.

Eustachian tube dysfunction may be due to underlying inhalant and/or food allergies. Even patients with refractory cases of patulous eustachian tube and eustachian tube obstruction who have not responded to traditional medical and surgical management may do well on specific allergy therapy.