Exploring the Connection of Otitis Media with Effusion and Allergic Rhinitis: A Systematic Review.

Abstract

Introduction: Otitis media with effusion (OME) is characterized by fluid accumulation in the middle ear behind an intact eardrum, often coexisting with allergic rhinitis, an inflammatory nasal condition causing symptoms such as nasal obstruction. Both conditions are prevalent in children and may share immune-mediated mechanisms linked to the unified airway concept. Previous studies suggest allergic rhinitis contributes to Eustachian-tube dysfunction and middle-ear effusion persistence, but the understanding of their interplay remains incomplete.

Objective: To evaluate the association between allergic rhinitis and OME, identifying risk factors, diagnostic methods, and potential therapeutic strategies.

Methods: The current systematic review adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a search on the PubMed database using the Medical Subject Headings (MeSH) otitis media with effusion and rhinitis, Allergic; we identified 181 articles, which were narrowed to 15 based on the inclusion criteria.

Results: Most studies revealed a significant association between allergic rhinitis and OME, particularly in children. Diagnostic methods such as intradermal dilution testing showed higher sensitivity than skin prick tests. Immunotherapy effectively addressed both conditions, even in cases with negative prick tests. Reduced micro ribonucleic acid (microRNA) 320e (miR-320e) expression was noted in allergic OME, suggesting potential as a biomarker. Surgical intervention provided symptom relief, but addressing underlying allergies proved essential. The studies were predominantly from China (20%) and the United States (13.3%).

Conclusion: Allergic rhinitis plays a crucial role in OME development and symptom exacerbation. Immunotherapy may serve as a preventive strategy, emphasizing the need for clinical guidelines. The present study bridges gaps in regional medical literature, offering valuable insights for clinicians and highlighting the need for further research to optimize pediatric care outcomes.