Does anti-allergy treatment prevent middle ear inflammation?
The large amount of experimental and clinical data supports the
hypothesis that treatment of atopy can have a beneficial effect on some
phenotype of otitis, and in particular in OME.
Accordingly,Mariño-Sánchezet al.supported the concept that AR is
associated to a higher severity and duration of OME andthat anti-allergy
treatment may improve outcomes in OME
patients.4However, it is difficult to demonstrate that
treatment of allergy can affect OME outcomes due to the contributing
factor of ET dysfunction and AH in the pathophysiology of OME.
Several studies have evaluated the role of oral steroids in OME
describing a potential benefit43, although long term
outcomes are not as clearly established as short term
ones.44 Children treated with intranasal mometasone
experienced higher resolution rates of OME compared with control
subjects, and the size of the adenoid tissue decreased more in atopic
children.45 Tracy and Demain46compared the effects of prophylactic antibiotics
alone or in combination with intranasal beclomethasone or placebo and
demonstrated that subjects in the beclomethasone plus antibiotic group
improved more rapidly than those in the antibiotic alone or placebo
group.Nevertheless, no differences were seen amongsubjects with and
without allergy. Chimona et al.47assessed the role of
antihistamines in OME in an animal experimental model, but no clinical
efficacy has been demonstrated for antihistamine alone or in association
with topical decongestantsin humans48, as confirmed by
a meta-analysis.49