Otitis media and nasal disease: a role for allergy

Otitis media with effusion (OME) is common in children, although it can occur at any age. Allergies probably contribute to the development of OME, with other major risk factors being bacterial infection and eustachian tube obstruction (ETO). We have demonstrated that patients with allergic rhinitis often develop ETO when challenged with allergens; therefore, ETO could be a link between OME and allergies. Nasal obstruction and ETO in allergic rhinitis can be alleviated or attenuated by pretreatment with intranasal corticosteroids. Therapy for allergic rhinitis complicated by OME includes treatment of the ear infection with antibiotics and the relief of allergic symptoms with antiallergy medications, including antihistamines, intranasal cromolyn, and intranasal corticosteroids, as well as environmental control and appropriate immunotherapy.