Tags

Type your tag names separated by a space and hit enter

Allergic rhinitis, histamine, and otitis media.
Allergy Asthma Proc. 2009 Sep-Oct; 30(5):470-81.AA

Abstract

Otitis media (OM) is a common and costly medical condition, especially in children. Most episodes of OM are associated with an upper respiratory viral infection and are short-lived and self-limiting with or without medical treatment. However, chronic OM with effusion (OME) has significant sequelae, is refractory to most medical treatments, and frequently requires surgical intervention. The pathophysiology of OME is complex and involves both eustachian tube (ET) dysfunction and middle ear pressure dysregulation. OM likely results from an increase in blood flow to and, thus, gas loss from the middle ear, in combination with a dysfunctional ET that can not resupply that gas. These processes could be induced by viral and/or allergen-driven inflammation. A large body of epidemiologic and mechanistic evidence supports a role for allergic rhinitis as a risk for OM. Indeed, evidence also supports a role for histamine in both conditions. However, not all such evidence is supportive of this relationship and a causal relationship between the two conditions has not been definitively proven. Moreover, therapeutic trials using common allergy therapies have either not been conducted or showed no benefit in OM. This prompted the 2004 clinical practice guidelines on OM to conclude that no recommendations could be made for "... allergy management as a treatment for OME based on insufficient evidence of therapeutic efficacy or a causal relationship between allergy and OME." Nonetheless, given the strong likelihood of allergy as a risk factor for OM, allergic rhinitis patients should be evaluated for OM and patients with OME should be considered for an allergy evaluation. If significant allergic rhinitis is diagnosed in a patient with OME, it should be treated aggressively (as in any case of moderate to severe allergic rhinitis) until further studies are conducted. No definitive conclusions about a role for food allergy in causing or treating OM can be made. Clearly, more studies are needed to examine the relationship between these two important conditions.

Authors+Show Affiliations

Juniata College, Huntington, Pennsylvania, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19843400

Citation

Skoner, Amanda R., et al. "Allergic Rhinitis, Histamine, and Otitis Media." Allergy and Asthma Proceedings, vol. 30, no. 5, 2009, pp. 470-81.
Skoner AR, Skoner KR, Skoner DP. Allergic rhinitis, histamine, and otitis media. Allergy Asthma Proc. 2009;30(5):470-81.
Skoner, A. R., Skoner, K. R., & Skoner, D. P. (2009). Allergic rhinitis, histamine, and otitis media. Allergy and Asthma Proceedings, 30(5), 470-81. https://doi.org/10.2500/aap.2009.30.3272
Skoner AR, Skoner KR, Skoner DP. Allergic Rhinitis, Histamine, and Otitis Media. Allergy Asthma Proc. 2009 Sep-Oct;30(5):470-81. PubMed PMID: 19843400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allergic rhinitis, histamine, and otitis media. AU - Skoner,Amanda R, AU - Skoner,Kelleen R, AU - Skoner,David P, PY - 2009/10/22/entrez PY - 2009/10/22/pubmed PY - 2009/12/29/medline SP - 470 EP - 81 JF - Allergy and asthma proceedings JO - Allergy Asthma Proc VL - 30 IS - 5 N2 - Otitis media (OM) is a common and costly medical condition, especially in children. Most episodes of OM are associated with an upper respiratory viral infection and are short-lived and self-limiting with or without medical treatment. However, chronic OM with effusion (OME) has significant sequelae, is refractory to most medical treatments, and frequently requires surgical intervention. The pathophysiology of OME is complex and involves both eustachian tube (ET) dysfunction and middle ear pressure dysregulation. OM likely results from an increase in blood flow to and, thus, gas loss from the middle ear, in combination with a dysfunctional ET that can not resupply that gas. These processes could be induced by viral and/or allergen-driven inflammation. A large body of epidemiologic and mechanistic evidence supports a role for allergic rhinitis as a risk for OM. Indeed, evidence also supports a role for histamine in both conditions. However, not all such evidence is supportive of this relationship and a causal relationship between the two conditions has not been definitively proven. Moreover, therapeutic trials using common allergy therapies have either not been conducted or showed no benefit in OM. This prompted the 2004 clinical practice guidelines on OM to conclude that no recommendations could be made for "... allergy management as a treatment for OME based on insufficient evidence of therapeutic efficacy or a causal relationship between allergy and OME." Nonetheless, given the strong likelihood of allergy as a risk factor for OM, allergic rhinitis patients should be evaluated for OM and patients with OME should be considered for an allergy evaluation. If significant allergic rhinitis is diagnosed in a patient with OME, it should be treated aggressively (as in any case of moderate to severe allergic rhinitis) until further studies are conducted. No definitive conclusions about a role for food allergy in causing or treating OM can be made. Clearly, more studies are needed to examine the relationship between these two important conditions. SN - 1539-6304 UR - https://www.unboundmedicine.com/medline/citation/19843400/Allergic_rhinitis_histamine_and_otitis_media_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=1088-5412&volume=30&issue=5&spage=470&aulast=Skoner DB - PRIME DP - Unbound Medicine ER -