The role of Allergy in Chronic Middle Ear Disease

Objective: OME is one of the most prevalent childhood diseases across the globe. OME is a disorder that most commonly begins in childhood but is seen in all ages and is the leading cause of hearing loss and speech difficulties, leading to impaired educational performance in children. This report will review the information that supports recent studies, which have shown that nearly 100% of OME patients are allergic and that when these allergies are properly treated, the patient’s effusion will resolve. Methods: In order to characterize the relation of allergy or infection to OME, we measured ECP, MPO, and tryptase in effusion from 97 patients. Biopsies from both normal and diseased patients were taken from the promontory of their middle ear and stained for mast cells. All patients underwent allergy testing. Results: Nearly all OME patients responded to immunotherapy. Conclusion: This data introduces a paradigm shift in the approach to children presenting with OME requiring tubes, as nearly 100% of OME patients are allergic, and unlike the use of antibiotics, which only treat the current episode, when their allergies were properly treated with immunotherapy, the patient’s tendency to experience recurrent effusions all resolved.