Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Brigham & Women's Hospital, 45 Francis Street ASB II, Boston, MA, 02115, USA.
Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, 110 Francis Street, Suite 6E, Boston, MA, 02115, USA.
Curr Allergy Asthma Rep. 2019 Sep 5;19(10):47. doi: 10.1007/s11882-019-0879-x.
To examine the role of allergy medications in the treatment of otitis media with effusion (OME), focusing on use of intranasal steroids and antihistamines.
There has been ongoing controversy regarding the role of allergy in the development of OME. Treatment of OME with medications commonly used for allergic symptomatology has been studied. Proposed treatment options include decongestants, mucolytics, oral steroids, topical steroids, antihistamines, and antibiotics. We begin by evaluating the proposed association between allergy and OME, and then evaluate intranasal steroids and oral antihistamine therapy in the treatment of OME. The role of the adenoid and concurrent nasal symptomatology is also addressed. The preponderance of data suggests that neither intranasal steroids nor antihistamines improve the long-term clearance of isolated OME and are therefore not recommended. However, data are notably limited with regard to improvement rates in OME in patients specifically with concurrent allergy and/or adenoid hypertrophy. Future studies of medications for OME would ideally incorporate study designs controlling for both allergic rhinitis and adenoid hypertrophy, to better understand the impact of these medications on OME in these subgroups of patients.
探讨过敏药物在分泌性中耳炎（OME）治疗中的作用，重点关注鼻内类固醇和抗组胺药的应用。
过敏在OME 发病机制中的作用一直存在争议。已经研究了用治疗过敏症状的常用药物治疗 OME。提出的治疗选择包括减充血剂、黏液溶解剂、口服类固醇、局部类固醇、抗组胺药和抗生素。我们首先评估过敏与 OME 之间的潜在关联，然后评估鼻内类固醇和口服抗组胺药治疗 OME 的作用。腺样体和同时存在的鼻部症状的作用也得到了探讨。大量数据表明，鼻内类固醇和抗组胺药均不能改善孤立性 OME 的长期清除率，因此不推荐使用。然而，关于同时伴有过敏和/或腺样体肥大的患者的 OME 改善率的数据明显有限。未来 OME 药物的研究最好纳入同时控制过敏性鼻炎和腺样体肥大的研究设计，以更好地了解这些药物对这些患者亚群中 OME 的影响。
