Antigen-induced eustachian tube obstruction: An intranasal provocative challenge test

Ackerman, M.; Friedman, Roger; Doyle, William J.; Bluestone, Charles D.; Fireman, Philip

doi:10.1016/0091-6749(84)90519-0

Cited by 66 publications

(24 citation statements)

References 16 publications

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“…Or is it a combination of both mechanisms? The lack of signifi cant MEP changes during the nasal challenges in the controls would not confi rm fi ndings of investigators who reported ET obstruction due to the nasal challenges with allergen in individuals with allergic rhinitis but without ME disease [27]. Most of the positive NRs to allergen challenge were accompanied by signifi cant changes in the MEP, indicating the involvement of nasal mucosal edema in ET dysfunction.…”

Section: Mechanisms Of Allergy Involvement In Chronic Sommentioning

confidence: 78%

Role of nasal allergy in chronic secretory otitis media

Pelikán¹

2009

Curr Allergy Asthma Rep

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Nasal allergy seems to be one of the important causes of chronic secretory otitis media (SOM) in children and adults. Chronic SOM is unequivocally related to disturbed function of the eustachian tube, which facilitates communication of the middle ear with the nasopharynx, nasal cavity, and indirectly with paranasal sinuses. The most serious consequences of chronic SOM are decreased elasticity of the tympanic membrane and hearing impairment. Allergic reactions in the nasal mucosa leading to release of various mediators result in development of three types of nasal response characterized predominantly by nasal obstruction. Eustachian tube functions can be affected directly by the mediators released in the nasal mucosa or indirectly by the nasal obstruction. Nasal challenges with allergens performed by rhinomanometry, combined with tympanometry and eventually audiometry, may be a useful diagnostic supplement for this disorder.

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Section: Mechanisms Of Allergy Involvement In Chronic Sommentioning

confidence: 78%

Role of nasal allergy in chronic secretory otitis media

Pelikán¹

2009

Curr Allergy Asthma Rep

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“…In addition, Doyle et al 25 and Tomonaga et al 26 failed to discover any MEE, even though they found allergic changes in the mucosa of animals passively sensitized and undergoing direct antigen injection into the tympanic cavity. Even if it is still unknown whether type I allergy is involved in the cause and pathogenesis of 28 showed that intranasal insufflation of pollen caused eustachian tube obstruction in patients with pollinosis. Osur et al 29 evaluated eustachian tube function in children with ragweed allergy using the 9-step pressure-swallowing test, and they demonstrated that the development of eustachian tube obstruction was found to correlate with ragweed skin test outcome, wheal size, and daily patient symptom scores.…”

Section: Discussionmentioning

confidence: 98%

Efficacy of an Antiallergic Drug on Otitis Media with Effusion in Association with Allergic Rhinitis; An Experimental Study

Suzuki¹,

Kawauchi²,

Kerakawauchi³

et al. 1999

Ann Otol Rhinol Laryngol

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The effect of an antiallergic drug on the evacuation of middle ear effusion (MEE) from the tubotympanum was investigated by means of an animal model with both otitis media with effusion (OME) and allergic rhinitis. Azelastine hydrochloride (AZ), an oral antiallergic drug, was administered and the presence of MEE was investigated. Serous MEE was seen in 12 of the 13 untreated control animals on the 11th day after the experimental OME was induced, whereas MEE was detected in 9 of the 13 animals administered 1 mg/kg of AZ, but only in 4 of the 13 animals administered 2 mg/kg of AZ. In addition, the effect of AZ on MEE production was also examined in an experimental OME animal model without allergic rhinitis. Middle ear effusion was observed in all OME animals that received 2 mg/kg AZ for 5 consecutive days, before and 3 days after the experimental OME was induced. Results of the present study indicate that AZ promotes the evacuation of MEE from the tubotympanum in the OME animal model associated with nasal allergy. These data suggest that an antiallergic drug may contribute to the therapy of OME patients in association with nasal allergy indirectly, by promoting evacuation of MEE due to inhibition of type I allergic reactions in the nasopharynx.

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“…For example, numerous studies in monkeys and humans showed that exposure of the nasal mucosa to histamine or to allergens in sensitized individuals caused the symptoms and signs of nasal inflammation/allergy and provoked a functional obstruction of the ET indicative of periluminal inflammation 18,19,22–27 . In pilot studies done in monkeys, nasal challenge with histamine was shown to cause a decreasing ME pressure and an increased MEM blood perfusion rate 20 and, as observed in the present study, to increase the transMEM N2O exchange-rate 21 .…”

Section: Discussionmentioning

confidence: 99%

Histamine Applied Topically to the Nasal Mucosa Increases the Transmucosal Nitrous Oxide Exchange for the Middle Ear

Teixeira

Alper

Martin

et al. 2017

Ann Otol Rhinol Laryngol

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Objective Determine if the middle-ear trans-mucosal Nitrous oxide (N2O) exchange-rate is affected by nasal inflammation caused by topical application of histamine. Methods In a randomized, double-blind, crossover study, twenty adults were challenged intra-nasally with histamine (5 mg) and placebo on separate occasions. At each session, the subjects were fitted with a non-rebreathing mask and breathed room-air for 20 minutes, 50% N2O:50% O2 for 20 minutes and 100% O2 for 10 minutes. Throughout, heart-rate, blood-pressure and blood O2-saturation were monitored and bilateral middle-ear pressure was recorded by tympanometry every minute. The primary outcome measure was the slope of the middle-ear pressure-time function for the 50% N2O:50% O2 breathing period which is a measure of the trans-mucosal N2O exchange-constant. The effects of Challenge Substance, Session and Period on the measured vital-signs and of Treatment, Session, Ear-Disease History and Test Ear on the pressure-time slopes were evaluated using repeated-measures ANOVAs. Results The post-challenge total-symptom-score and the slope of the middle-ear pressure-time function were greater after histamine when compared to placebo challenge. Of the signs, only heart-rate was affected, responding to Challenge Substance and Study Period. Conclusion The trans-mucosal N2O exchange-rate for the middle ear is increased during inflammation caused by nasal histamine exposure.

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Antigen-induced eustachian tube obstruction: An intranasal provocative challenge test

Cited by 66 publications

References 16 publications

Role of nasal allergy in chronic secretory otitis media

Role of nasal allergy in chronic secretory otitis media

Efficacy of an Antiallergic Drug on Otitis Media with Effusion in Association with Allergic Rhinitis; An Experimental Study

Histamine Applied Topically to the Nasal Mucosa Increases the Transmucosal Nitrous Oxide Exchange for the Middle Ear

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