Role of nasal allergy in chronic secretory otitis media

Abstract

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.

Detection of bacteria in middle ear effusions based on the presence of allergy: Does allergy augment bacterial infection in the middle ear?

“…Theoretically, nasal obstruction due to an allergy can lead to an increase in negative pressure in the nasopharynx, resulting secondarily in decreased Eustachian tube patency, and disturbance of its ciliary epithelial function with subsequent increase in the negative pressure in the middle ear cavity. Several theories have been proposed to explain the Eustachian tube dysfunction caused by allergic inflammation, including retrograde spread of edema, poor mucociliary function, and venous engorgement and hypersecretion of mucus [ 3 ]. It has been suggested that the development of OME is the result of improperly functioning barriers (mucociliary system, immune system, and Eustachian tube) conferring resistance to bacteria [ 13 ].…”

“…It has been suggested that the development of OME is the result of improperly functioning barriers (mucociliary system, immune system, and Eustachian tube) conferring resistance to bacteria [ 13 ]. The pathogenesis of OME is related primarily to Eustachian tube dysfunction, including obstruction, abnormal patency, and non-optimally functioning ciliated epithelium [ 3 , 14 ]. These conditions can facilitate the aspiration of nasopharyngeal secretions containing pathogenic bacteria into the middle ear cavity, leading to the development of OME.…”

“…The negative finding of our study indicates that the anatomical immaturity of the Eustachian tube in children may plays a major role in the development of OME due to the bacterial infection rather than allergy. Chronic OME due to Eustachian tube dysfunction caused by allergy tends to occur much more frequently in adults than in children [ 3 ]. The analysis of differences of the detection rates among various age groups was not performed in this study.…”

Resultados Anatómicos Y Audiológicos en Timpanoplastia Tipo I La Población Pediatrica

“…Ribeiro (4) encontró que la adenoidectomía en niños mayores de 10 años fue un predictor independiente de éxito funcional, probablemente debido a la mejor función tubárica. Gamra encontró que la rinitis alérgica fue un factor contribuyente al fracaso de la cirugía (p<0,001), debido tal vez a los mediadores inflamatorios liberados en la mucosa nasal o indirectamente por la obstrucción (29).…”

The Atopy Index Inventory: A Brief and Simple Tool to Identify Atopic Patients

“…As a consequence, atopy produces allergy with the typical symptoms of asthma, rhino conjunctivitis, or eczema. Atopy has been associated with several ear, nose, and throat (ENT) disorders, such as otitis media with effusion [1][2][3][4], adenoid hypertrophy [5][6][7], rhinitis and sinusitis [8,9], Ménière disease [10][11][12], and Reinke edema [13]. When a patient is referred for one of these common diseases, ENT specialists usually address the existence of an allergic substrate by means of a direct, time-consuming interview or empiric treatments [14].…”