In Reply.—Dr Wilson neglects to consider a most promising upper respiratory mechanism by which an IgE-mediated allergic reaction could result in otitis media with effusion (OME). This hypothesis suggests the development of eustachian tube obstruction secondary to allergic rhinitis. A number of recent studies in our laboratories have shown that provocative intranasal challenge with either allergens or histamine in allergic subjects induces a severe functional obstruction of the eustachian tube,1-6 which has been previously shown to underly the pathogenesis of OME.7 We propose that continued study of this phenomenon should better define the role of respiratory allergy in the pathogenesis of OME. These studies may obviate the enthusiasm with which Dr Wilson and others rush to implicate gastrointestinal tract allergy in the pathogenesis of OME.
DOYLE WJ, FIREMAN P. The Role of Allergy in Otitis Media With Effusion-Reply. Arch Otolaryngol Head Neck Surg. 1986;112(4):455. doi:10.1001/archotol.1986.03780040094023
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