The role of nasal allergy in chronic secretory otitis media.
BACKGROUND
Chronic secretory otitis media (SOM) has multifactorial causes, and nasal allergy is suspected as one of these causative factors.


OBJECTIVE
To investigate the possible role of nasal allergy in SOM in adults and to determine the diagnostic value of nasal challenges with allergens (nasal provocation tests) combined with tympanometry for the diagnosis of this disorder.


METHODS
In 69 young adults with chronic or recurrent SOM, 173 nasal challenges with allergens were performed by anterior rhinomanometry combined with tympanometry (pure-tone air conduction tympanometry). In 42 control subjects with only allergic rhinitis and no history of middle ear disease, 42 nasal challenges with allergens were repeated and combined with tympanometry. The study design was a placebo-controlled comparison.


RESULTS
Of the 69 patients, 54 developed 129 positive nasal responses of various types (P < .01), 117 of which were accompanied by significant changes in middle ear pressure (P < .01). No significant tympanometric changes (P > .10) were recorded during the 42 positive nasal responses in control subjects.


CONCLUSIONS
These results may confirm the occurrence of chronic SOM in some adult patients and the possible involvement of nasal allergy in chronic SOM. The nasal challenges with allergen performed by rhinomanometry, combined with tympanometry, seem to be a valuable supplementary tool for the diagnosis of this disorder.
Pelikan
Zdenek
Z
Allergy Research Foundation, Breda, The Netherlands. zpelikan@casema.nl
D000158:Acoustic Impedance Tests; D000328:Adult; D002908:Chronic Disease; D005064:Eustachian Tube / Q000473:pathology; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000276:immunology / Q000473:pathology; D009299:Nasal Provocation Tests; D010034:Otitis Media with Effusion / Q000209:etiology* / Q000473:pathology; D012220:Rhinitis / Q000150:complications* / Q000276:immunology / Q000473:pathology; D012882:Skin Tests