Abstract
The role of IgE-mediated hypersensitivity in the development of middle ear disease has not been completely resolved. However, on the basis of our investigations and those of other laboratories, we would suggest that approximately two-thirds of patients with chronic recurrent otitis media (OM) are not allergic. The other third may have allergic rhinitis, and this allergic rhinitis may play a direct role in producing eustachian tube dysfunction in recurrent OM. However, viral infections of the upper respiratory tract may also induce IgE-mediated release of mast cell inflammatory mediators and could cause OM on the basis of viral infection alone. The role of allergic rhinitis on eustachian tube dysfunction is now well documented, and finally, the possible role of food allergy and OM must be seriously considered, particularly in the young OM-prone child with chronic recurrent rhinitis and OM.
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