To the Editor.—Due to problems of medicolegal exposure, the need to obtain informed consent from parents, plus the expense of conducting such a study, Dr Thomsen and coworkers, in the April issue of the Archives,1 indicate that there are few choices in the nonsurgical treatment of serous otitis media.
I would like to comment that there is another choice that is generally forgotten, both in Denmark and in the United States, and that is recognition and treatment of allergic rhinitis, usually due to hidden food allergies. Referral of patients to conventional allergists is fruitless in these children, as general allergists confine their investigations to inhalants, and inhalants are less frequently a cause of allergic rhinitis than are foods in children under the age of 6 years.
Clinical ecologists who recognize the importance of foods and, sometimes, chemicals in causing serous otitis media are able to help in detecting
SHAMBAUGH GE. Antibiotic Treatment of Children With Secretory Otitis Media. Arch Otolaryngol Head Neck Surg. 1990;116(1):108. doi:10.1001/archotol.1990.01870010112030