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The links between allergy and otitis media with effusion

Tewfik, Ted L.a; Mazer, Bruceb

Current Opinion in Otolaryngology & Head and Neck Surgery: June 2006 - Volume 14 - Issue 3 - p 187-190
doi: 10.1097/01.moo.0000193190.24849.f0

Purpose of review In this review we will examine evidence indicating that allergic inflammation is present in middle ear effusion. We will also discuss several of the problems relating to the diagnosis of allergy and allergic sensitization, and why anti-allergy treatments have been unsuccessful. This will provide a rationale for future studies in the field linking allergic inflammation with otitis media with effusion.

Recent findings Recent findings in atopic children demonstrated higher levels of eosinophils, T lymphocytes, and interleukin-4+ and interleukin-5+ cells compared with nonatopic patients. T-helper 2 cells and cytokines were found not only in middle ear effusions in atopic children but also in specimens from adenoid tissue. This demonstrates a strong correlation between allergic reaction in the middle ear and the upper airway.

Summary In summary, as our knowledge of the allergic and nonallergic influences on inflammation broadens, the paradigms of treatment may be altered. The accumulating experimental and clinical data suggest that it may be wiser to screen every child with otitis media with effusion for allergic rhinitis and ultimately to manage those with allergic inflammation differently to nonatopic individuals with otitis media with effusion.

aDepartment of Otolaryngology, McGill University, Montreal, Canada

bDepartment of Pediatrics, McGill University, Montreal, Canada

Correspondence to Professor Ted L. Tewfik MD, FRCSC, Montreal Children's Hospital – MUHC, 2300 Tupper Street, Suite B-240, Montreal, PQ, H3H 1P3, Canada. Tel: +1 514 412 4342; fax: +1 514 412 4342; E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.