Can serous otitis media occur with allergies?

From the Guidelines

Yes, serous otitis media can occur with allergies. Allergies can cause inflammation and congestion of the nasal passages and Eustachian tube, leading to fluid buildup in the middle ear without infection, known as serous otitis media. This happens because the Eustachian tube, which normally drains fluid from the middle ear, becomes blocked due to the allergic response.

Key Points to Consider

• The relationship between allergies and serous otitis media is supported by studies such as 1, which highlights the association between allergic rhinitis and otitis media with effusion.
• Treatment typically includes managing the underlying allergy with antihistamines like cetirizine (10mg daily) or loratadine (10mg daily), nasal corticosteroids such as fluticasone (1-2 sprays per nostril daily), and decongestants like pseudoephedrine (30-60mg every 4-6 hours) for short-term use.
• Nasal saline irrigation can help clear allergens and reduce congestion.
• If fluid persists despite allergy management, a healthcare provider might recommend a short course of oral steroids or consider referral to an ENT specialist for possible myringotomy (ear tube placement) if the condition becomes chronic or causes significant hearing loss.
• Treating the allergies effectively is crucial for preventing recurrent episodes of serous otitis media, as emphasized in 1 and 1, which discuss the management of otitis media with effusion and the role of tympanostomy tubes in children.

From the Research

Serous Otitis Media and Allergies

• Serous otitis media, also known as otitis media with effusion (OME), is a condition where fluid accumulates in the middle ear behind the eardrum [(2,3,4,5,6)].
• Research suggests that allergies may play a role in the development of OME, particularly in children [(2,4,5)].
• Studies have found that patients with OME are more likely to have allergic rhinitis and other allergic diseases compared to those without OME [(2,5)].
• The relationship between allergies and OME is complex, and while some studies support a causal link, others have found no definitive connection [(2,4)].

Allergic Rhinitis and Serous Otitis Media

• Allergic rhinitis is a common allergy that may contribute to the development of OME [(2,5)].
• Patients with serous OME are more likely to have allergic rhinitis compared to those with mucous or purulent OME 5.
• Treating allergic rhinitis aggressively may help improve symptoms of OME in some patients [(2,6)].

Diagnosis and Treatment

• Diagnostic tests such as RAST testing, skin end point titration, and food elimination diets may help identify an allergic etiology in patients with refractory serous OME 6.
• Allergy immunotherapy and food elimination diets have been shown to be effective in resolving symptoms of OME in some patients 6.
• Further studies are needed to fully understand the relationship between allergies and OME, and to develop effective treatment strategies [(2,4,5)].