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Role of allergy in eustachian tube blockage and otitis media with effusion: a review.
Otolaryngol Head Neck Surg. 1996 Apr; 114(4):562-8.OH

Abstract

Recent studies continue to support a role for allergy in the pathogenesis of otitis media with effusion. Although a variety of mechanisms have been proposed to relate these two disease conditions causally, none has been completely validated by experimental or clinical studies. This review suggests that the observed relationship between allergy and otitis media with effusion is caused by mediators of inflammation and cytokines and colony-stimulating factors released by mucosal mast cells and other inflammatory and epithelial cells in the nose and nasopharynx. These mediators produce blockage of the eustachian tube through a number of mechanisms, which may include local injury or vascular- or neural-mediated changes in the eustachian tube opening pressure and in middle ear perfusion. It is likely that the nasal allergic response in patients predisposes to eustachian tube blockage and, if prolonged, causes changes in gas absorption in the middle ear space. This gas exchange primarily involves nitrogen absorption, which may take several days to develop. This persistent underpressure will then lead to middle ear effusion. Irrespective of the theoretical mechanism, the relationship between allergy and otitis media with effusion will remain controversial until well-controlled clinical studies are conducted documenting that in select populations antiallergy therapy is efficacious in preventing or limiting the duration of otitis media with effusion.

Authors+Show Affiliations

Departments of Otolaryngology, Pediatrics, and Speech and Language Sciences, State University of New York at Buffalo, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

8643265

Citation

Bernstein, J M.. "Role of Allergy in Eustachian Tube Blockage and Otitis Media With Effusion: a Review." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 114, no. 4, 1996, pp. 562-8.
Bernstein JM. Role of allergy in eustachian tube blockage and otitis media with effusion: a review. Otolaryngol Head Neck Surg. 1996;114(4):562-8.
Bernstein, J. M. (1996). Role of allergy in eustachian tube blockage and otitis media with effusion: a review. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 114(4), 562-8.
Bernstein JM. Role of Allergy in Eustachian Tube Blockage and Otitis Media With Effusion: a Review. Otolaryngol Head Neck Surg. 1996;114(4):562-8. PubMed PMID: 8643265.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of allergy in eustachian tube blockage and otitis media with effusion: a review. A1 - Bernstein,J M, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 562 EP - 8 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 114 IS - 4 N2 - Recent studies continue to support a role for allergy in the pathogenesis of otitis media with effusion. Although a variety of mechanisms have been proposed to relate these two disease conditions causally, none has been completely validated by experimental or clinical studies. This review suggests that the observed relationship between allergy and otitis media with effusion is caused by mediators of inflammation and cytokines and colony-stimulating factors released by mucosal mast cells and other inflammatory and epithelial cells in the nose and nasopharynx. These mediators produce blockage of the eustachian tube through a number of mechanisms, which may include local injury or vascular- or neural-mediated changes in the eustachian tube opening pressure and in middle ear perfusion. It is likely that the nasal allergic response in patients predisposes to eustachian tube blockage and, if prolonged, causes changes in gas absorption in the middle ear space. This gas exchange primarily involves nitrogen absorption, which may take several days to develop. This persistent underpressure will then lead to middle ear effusion. Irrespective of the theoretical mechanism, the relationship between allergy and otitis media with effusion will remain controversial until well-controlled clinical studies are conducted documenting that in select populations antiallergy therapy is efficacious in preventing or limiting the duration of otitis media with effusion. SN - 0194-5998 UR - https://www.unboundmedicine.com/medline/citation/8643265/Role_of_allergy_in_eustachian_tube_blockage_and_otitis_media_with_effusion:_a_review_ L2 - https://journals.sagepub.com/doi/10.1016/s0194-5998(96)70247-4?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -