Allergy and the immunologic aspects of otitis media with effusion.

We reviewed the literature since 1980, and discovered that there is a distinct small subset of patients with otitis media with effusion (OME) in whom the middle ear acts as a shock organ for an IgE-mediated, type I allergic reaction. In the majority of patients, however, no direct relationship between the type I reaction and OME can be drawn. Both the type III and type IV reactions are strongly incriminated in the pathogenesis of OME. Much work remains to be done to clarify the exact role of the immune system in OME.