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Chronic serous otitis media, also called Otitis Media with Effusion (OME), is a chronic inflammatory condition which is categorized by the persistent presence of effusion, in cases where acute inflammation is not present.1
Although most of the problems with OME are associated with infections, allergic sensitizations can be a risk factor for recurrent episodes of the illness. It is thought that approximately 20% of patients with OME have a contributing underlying allergy.2 There is also a significant correlation between OME and allergic disease.3
Frequent exposure to allergens, e.g. cats and dogs
A personal or family history of allergy
Presence of associated allergic disease
Persistent chronic serous otitis media or recurrent acute otitis media may result in destructive changes in the middle ear. It can cause hearing loss or impaired hearing, which can interfere with language and speech development if it happens at critical times during a child’s life.1
An allergy-focused patient history5 can provide you with a more detailed history and allow you to effectively manage your patient.
Guided by the findings of your allergy-focused patient history, you may want to consider allergy testing as the most appropriate next step. Specific IgE blood tests, skin prick tests (SPT), or both are important diagnostic tools. Skin prick testing and specific IgE measurements can help you rule in or rule out allergen sensitization, which may give you the ability to correctly diagnose and improve clinical management.6,7 The patient medical history should be supplemented by allergen sensitization testing for accurate results.8
Unfortunately, symptoms of OME are often exacerbated by coexisting allergies. To further complicate diagnosis and treatment is the fact that up to 80% of patients with allergies are sensitized to more than one allergen.9
Paying close attention to a patient’s presenting symptoms can help steer you toward testing that can identify the relevant sensitizing allergens. This information may be able to help you outline a comprehensive management plan, which may include avoiding known allergens, that can keep your patient below his or her symptom threshold.
Unfortunately, chronic serous otitis media symptoms are often exacerbated by coexisting allergies. To further complicate diagnosis and treatment is the fact that up to 80% of patients with allergies are sensitized to more than one allergen.9
Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M. Update on otitis media – prevention and treatment. Infection and Drug Resistance. 2014;7:15-24. doi:10.2147/IDR.S39637.
Tomonaga, K, Kurono, Y, Mogi, G. The role of nasal allergy in otitis media with effusion. A clinical study. Acta Otolaryngol Suppl. 1988;458:41-47.
Passali D, Passali GC, Lauriello M, Romano A, Bellussi L, Passali FM. Nasal Allergy and Otitis Media: A real correlation? Sultan Qaboos University Medical Journal. 2014;14(1):e59-e64.
Fireman P. Otitis media and eustachian tube dysfunction: connection to allergic rhinitis. J Allergy Clin Immunol. 1997 Feb;99(2):S787–S797
Pawankar R, Holgate S, Canonica G, at el. World Allergy Organization. White Book on Allergy (WAO). 2011. http://www.worldallergy.org/UserFiles/file/WAO-White-Book-on-Allergy_web.pdf. Accessed December 2017.
Duran-Tauleria E, Vignati G, Guedan MJ, et al. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59 (Suppl 78):35-41.
Niggemann B, Nilsson M, Friedrichs F. Paediatric allergy diagnosis in primary care is improved by invitro allergen specific IgE testing. Pediatr Allergy Immunol. 2008;19:325-331.
Smith HE, Hogger C, Lallemant C, et al. Is structured allergy history sufficient when assessing patients with asthma and rhinitis in general practice? J Allergy Clin Immunol. 2009;123:646-650.
Ciprandi G, Alesina R, Ariano R, et al. Characteristics of patients with allergic polysensitization: the POLISMAIL study. Eur Ann Allergy Clin Immunol. 2008;40(3):77-83.