Otitis media and eustachian tube dysfunction: Connection to allergic rhinitis☆☆☆★

Fireman, Philip

doi:10.1016/s0091-6749(97)70130-1

Cited by 155 publications

(118 citation statements)

References 68 publications

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“…Though allergic rhinitis is accepted as one of the leading causes of ET dysfunction and OME in many studies none of these studies include TM retraction as feature associated with AR. [3][4][5][6]9 Since Eustachian tube dysfunction will lead to negative middle ear pressure, TM retraction can develop in these patients. The reason for not seeing a statistically significant correlation between duration of symptoms and TM retraction may be due to the fact that these patients may have compromised ET function and thus retraction of TM only during exacerbation of symptoms and not as a persistent feature.…”

Section: Discussionmentioning

confidence: 99%

“…In the study by Philip Fireman MD, it is stated that if allergic rhinitis is documented in association with OME, management of the allergic rhinitis includes antihistamine therapy and avoidance of offending allergens. 4 If these are not effective, intranasal corticosteroids, intranasal cromolyn, and allergen immunotherapy may be considered.…”

Section: Discussionmentioning

confidence: 99%

“…4 Even if eustachian tube obstruction is minimal, patients with allergic rhinitis may have symptoms of eustachian tube dysfunction, such as popping and snapping sounds in the ear. These symptoms may be aggravated during airplane travel.…”

Section: Introductionmentioning

confidence: 99%

“…There are many studies from various countries implicating allergic rhinitis as a cause of Eustachian tube dysfunction and otitis media. [3][4][5][6] There is a study of Eustachian tube function in adults with intact tympanic membrane from Brazil. 7 In this study allergy is considered as one of the causes of Eustachian dysfunction in patients with intact tympanic membrane.…”

Section: Introductionmentioning

confidence: 99%

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Observational study of tympanic membrane changes in allergic rhinitis

2016

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INTRODUCTIONApproximately 20% to 30% of total population suffers from at least one type of allergic diseases in India. A study carried, over 30 years ago in Delhi reported around 10% allergic rhinitis and 1% asthma in 1964.1 There after later studies have reported that 20% to 30% of the population suffer from allergic rhinitis and of that 15% develop asthma.Approximately 20% of adults and children have seasonal or perennial allergic rhinitis.2 Despite its prevalence, the condition is often treated inadequately and becomes chronic. A chronic state of nasal inflammation and obstruction develops, frequently leading to more serious complications in both the upper and the lower airways and the middle ear. 3The eustachian tube provides an anatomic communication between the nasopharynx and the middle ear and is in a unique position to cause changes in the middle ear secondary to reactions in the nose.Upper respiratory tract allergy may cause some intrinsic and extrinsic mechanical obstruction in patients who have ABSTRACT Background: Allergic rhinitis (AR) is a common condition affecting 20-30% of the population. This condition affects not only the nose but also the sinuses and ears in many ways. Many studies are there worldwide implicating AR as a cause of serous otitis media. But only few studies have actually studied the tympanic membrane (TM) changes observed in patients with allergic rhinitis. The aim of this study is to document the TM changes observed in patients with AR and to correlate them with the duration of symptoms and also influence of prior treatment of AR on the TM changes observed. Methods: A total of 111 patients and so 222 ears were studied. A detailed history of the duration of symptoms and any prior treatment for AR was recorded. The TM changes seen were classified and recorded. The duration of disease and treatment were taken as grouping variables and the tympanic membrane changes were ranked and used as testing variable. The results were statistically analyzed using non-parametric test, Kruskal -Wallis test. Results: There was no statistically significant correlation between duration of AR and the TM changes observed. However there was a significantly less number of patients with TM retraction observed in the patients who had taken prior treatment compared to those patients who had taken no prior treatment. Conclusions: It is concluded that institution of early treatment may prevent development of Eustachian tube dysfunction and TM changes in patients with AR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Observational study of tympanic membrane changes in allergic rhinitis

2016

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“…A negative middle ear pressure is characterized by retraction of the tympanic membrane, prominence of the lateral process of the malleus, a more horizontal orientation of the manubrium of the malleus, and increased mobility of the tympanic membrane when the insufflation creates negative pressure in the external ear canal. 23,24 Although prominence of the lateral process of the malleus and orientation of the malleus can be observed using video-otoscopic images, the assessment of mobility of the tympanic membrane requires either pneumatic otoscopy or tympanometry to elicit the required response. A retracted tympanic membrane is …”

Section: Discussionmentioning

confidence: 99%

Asynchronous Video-Otoscopy with a Telehealth Facilitator

Biagio

Swanepoel

Adeyemo

et al. 2013

Telemedicine and e-Health

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Objective: The study investigated whether video-otoscopic images taken by a telehealth clinic facilitator are sufficient for accurate asynchronous diagnosis by an otolaryngologist within a heterogeneous population. Subjects and Methods: A within-subject comparative design was used with 61 adults recruited from patients of a primary healthcare clinic. The telehealth clinic facilitator had no formal healthcare training. On-site otoscopic examination performed by the otolaryngologist was considered the gold standard diagnosis. A single video-otoscopic image was recorded by the otolaryngologist and facilitator from each ear, and the images were uploaded to a secure server. Images were assigned random numbers by another investigator, and 6 weeks later the otolaryngologist accessed the server, rated each image, and made a diagnosis without participant demographic or medical history. Results: A greater percentage of images acquired by the otolaryngologist (83.6%) were graded as acceptable and excellent, compared with images recorded by the facilitator (75.4%). Diagnosis could not be made from 10.0% of the video-otoscopic images recorded by the facilitator compared with 4.2% taken by the otolaryngologist. A moderate concordance was measured between asynchronous diagnosis made from videootoscopic images acquired by the otolaryngologist and facilitator (j = 0.596). The sensitivity for video-otoscopic images acquired by the otolaryngologist and the facilitator was 0.80 and 0.91, respectively. Specificity for images acquired by the otolaryngologist and the facilitator was 0.85 and 0.89, respectively, with a diagnostic odds ratio of 41.0 using images acquired by the otolaryngologist and 46.0 using images acquired by the facilitator. Conclusions: A trained telehealth facilitator can provide a platform for asynchronous diagnosis of otological status using video-otoscopy in underserved primary healthcare settings.

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