The role of IgE-mediated immunity in otitis media: fact or fiction?

As both OME and allergic rhinitis are common among young children, these disorders are occasionally seen in the same patients. Many clinical and experimental studies have denied the allergic etiology of OME, although type I allergic reactions in the nose cause tubal obstruction without inducing MEE because the induced obstruction remains for a short duration. An animal model study demonstrated that allergy-induced tubal obstruction disturbs the clearance of MEE significantly. Since a clinical and an experimental study showed the efficacy of allergic treatment in patients or animals having both diseases, allergy and OME should be treated simultaneously in patients with both diseases. Viral infections of the upper respiratory tract induce viral-specific IgE antibodies, which may cause mucosal inflammatory reactions similar to those seen in type I allergy. Viral infection also triggers bacterial infection. Consequently, viral infection is a critical factor in the etiopathogenesis of OME.