Audiological Investigation of Otitis Media in Children with Atopy

Abstract

Otitis media (OM) describes an inflammatory process within the middle ear space that is generally associated with accumulation of fluid and that may lead to hearing loss, learning difficulties, and delays in language development. The pathogenesis of OM is multifactorial, involving the adaptive and native immune system, eustachian tube dysfunction, viral and bacterial load, and genetic and environmental factors. The involvement of IgEmediated allergic reactions in the pathogenesis of OM has been suggested by clinical observations of a high prevalence of OM among patients with allergies. Evidence from studies involving tympanometric measurements, audiometric measurements, and otoscopic examination confirms the role of atopy in the development and persistence of OM.

Prevalence and risk factors of otitis media with effusion in school children in Eastern Anatolia

“…In this context, a transient Eustachian tube opening results in aspiration into the middle ear cavity of nasopharyngeal secretions containing bacteria and viruses with the obvious physiopathological consequences. Several studies have shown a predominance of eosinophils, T lymphocytes, and Th2 mediators in the middle ear effusion, providing evidence that the inflammation within the middle ear of OME patients is allergic in nature [51]. In their study, Martines et al found that a total of 42.85% of the atopic population was suffering from OME, while the percentage with OME among nonatopic individuals was 6.29% [52].…”

“…It is the genetic predisposition, transmitted as a dominant factor, to become allergic to a definite number of specific allergens [50]. Evidence from studies involving tympanometric measurements, audiometric measurements, and otoscopic examination confirms the role of atopy in the development and persistence of OM [51]. Nasal allergic inflammation leads to swelling and obstruction of the Eustachian tube, which in turn determines a negative pressure in the middle ear and improper ventilation.…”

AAOA allergy primer: history and physical examination

“…Urticaria, angioedema, complaints of increased mucus, and wheezing (particularly expiratory wheezing) are other potential allergic symptoms. Other, less well‐known, less specific symptoms that may indicate allergy include complaints of chronic nasal congestion; postnasal drainage; coughing; frequent sinus infections; change in hearing, ear pressure, or pain; the feeling of ears being stopped up or congested; itchy throat; hoarseness; heartburn; gastrointestinal upset; snoring; and tiredness or fatigue . These symptoms include other disease processes, such as asthma, chronic rhinosinusitis, Eustachian tube dysfunction, obstructive sleep apnea, and otitis media, which can be exacerbated by allergies …”

“…Nasopharyngeal edema around the Eustachian tube (ET) from inhalant allergies that results in ET dysfunction is thought to contribute to the development of serous, noninfected fluid in the middle ear space . The middle ear mucosa is also thought to be a target end‐organ for allergic inflammation and is associated with the development of serous effusions …”

Otitis Media with Effusion in Children: A Follow up Study in West Baghdad, Iraq

“…When inadequately treated or left untreated, OME may lead sequelae and complications, consisting in acute otitis media with tympanic perforation, retraction pockets, tympanosclerosis, adhesive otitis media, cholesteatoma all clinical conditions characterized in children by permanent hearing loss and impairment in development of speech and language [12][13][14]. The association of OME with the Eustachian Tube (ET) dysfunction and the disorders of the nose have repeatedly been confirmed [4].…”