title: Allergic Rhinitis in Adults with Chronic Suppurative Otitis Media.
abstract: BACKGROUND
  Chronic suppurative otitis media (CSOM) is considered one of the most common causes of acquired hearing impairment in developing countries. CSOM is a multifactorial persistent inflammatory disease of the middle ear. A distinct pathophysiologic mechanism linking allergic rhinitis (AR) and CSOM remains to evolve. The purpose of this study was to investigate the association between AR and CSOM in adults.This was a case-control study.
  
  
  METHODS
  The subjects were 62 adults (23 male, 39 female) with established CSOM and 61 healthy controls. CSOM was diagnosed when there was a history of chronic (persisting for at least 3 months) otorrhea, accumulation of mucopurulent exudates in the external auditory canal or middle ear and/or perforated tympanic membrane on otoscopy. All participants were evaluated for the presence of AR by clinical evaluation of allergic symptoms, and underwent a skin-prick test for 23 common regional allergens. Statistical analysis was performed using SPSS version 16.
  
  
  RESULTS
  The prevalence of clinical rhinitis (allergic and non-allergic) was significantly higher among the cases compared with controls (62.5% vs. 37.5%, P=0.02). The prevalence of AR (proven by positive skin-prick test) was also significantly higher among affected adults than controls (24.6% and 13.8%, respectively). Adjusting for age, a logistic regression model showed that there was a significant difference between the two groups. Patients with AR and non-AR were at 3.27- (95% CI=1.15-9.29; P=0.036) and 2.57-(95% CI=1.01-6.57; P=0.048) fold increased risk of developing CSOM, respectively, compared with healthy individuals.
  
  
  CONCLUSIONS
  The study showed a higher prevalence of AR in CSOM patients than in controls. It may be valuable to evaluate and control this factor in these patients.
authors.affiliation: Sinonasal Diseases Research Centre, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Shadman
authors.initials: S
authors.lastname: Nemati
authors.affiliation: Department of Immunology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Jafari Shakib
authors.affiliation: Department of Epidemiology, School of Public Health, Shahid Beheshti University of medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Shakiba
authors.affiliation: Department of Otolaryngology, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Nematollah
authors.initials: N
authors.lastname: Araghi
authors.affiliation: Sinonasal Diseases Research Centre, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Seyyede Zeinab
authors.initials: SZ
authors.lastname: Azimi
keywords: Allergic; Hypersensitivity; Otitis Media; Otorhinolaryngologic diseases; Rhinitis; Skin test; Suppurative