Detection of allergic disease in adenoid tissue.

Allergic adenoiditis is defined as the presence of numerous brightly fluorescent IgE mast cells (FIEMC) demonstrated in formalin-fixed adenoid tissue by the trypsin-immunofluorescent method. A prospective study of 606 routinely accessioned cases seen during a 39-month period revealed 98 positive cases. Correlation with clinical and other allergic diagnostic testing revealed a sensitivity of 58% and a specificity of 89%. The pathogenetic role of allergy in chronic otitis media with effusion appears to be related to an exaggerated immediate hypersensitivity response to an allergen and/or infectious agent leading to dysfunction of the eustachian tube. The proximity and shared mucosa of adenoid tissue and eustachian tube allow the recognition of this inflammatory event.