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Chronic Otitis Media

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 

Clues that your patient’s condition may be related to allergy include:4

Symptoms

Frequent exposure to allergens, e.g. cats and dogs

Allergic disease

A personal or family history of allergy

Exposure to allergens

Persistent symptoms


Associated allergic disease

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

Testing Improves Diagnostic Certainty

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

Learn more about how testing can help you diagnose allergy >

Allergic Triggers of OME

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.

Chronic serous otitis media

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

Allergy Testing

Tests

Diagnostic tests give reliable results that support primary care physicians as well as specialists in providing optimal patient management.

References
  1. 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.

  2. 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.
 

  3. 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.

  4. Fireman P. Otitis media and eustachian tube dysfunction: connection to allergic rhinitis. J Allergy Clin Immunol. 1997 Feb;99(2):S787–S797

  5. 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. 

  6. 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. 

  7. 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.  

  8. 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. 

  9. 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.