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