Physiopathologic theory linking allergy to increased risk of
middle ear inflammation.
Multiple hypotheses may explain the link between allergy and otitis
media, even if a definitive mechanism has not been
identified.14 The “shock organ” hypothesis
speculates that the middle ear may act as a shock organ responding to
antigen similar to nasal and bronchial mucosa, according to the unified
airway theory hypothesizing that the respiratory tract may behave as one
integrated unit. The “Eustachian tube dysfunction” theory speculates
that allergy may lead to edema of nasal mucosa, muco-ciliary impairment,
and ET ostium blockage, reducing middle ear ventilation and continuous
negative pressure, and promoting otitis. Eventually, the most recent
hypothesis is that ET dysfunction may be related to chronic inflammation
of lymphoid tissues such as adenoids with retrograde aspiration of
bacteria and nasopharyngeal secretion into the middle ear cavity.