Nsouli T M, Nsouli S M, Linde R E, O'Mara F, Scanlon R T, Bellanti J A
Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.
Ann Allergy. 1994 Sep;73(3):215-9.
The relationship between IgE-mediated hypersensitivity and recurrent serous otitis media has not been completely established.
The purpose of the present study was to examine the prevalence of food allergy in patients with recurrent serous otitis media.
A total of 104 unselected patients (age range 1.5 to 9 years, mean 4.6 years) with recurrent serous otitis media were evaluated for food allergy by means of skin prick testing, specific IgE tests, and food challenge. Patients who were allergic to food(s) underwent an exclusion diet of the specific offending food(s) for a period of 16 weeks. A non-double blinded food challenge was performed with the suspected offending food(s). Their middle ear effusion was monitored and assessed by tympanometry (Welch Allyn Model 23600) during the pre-elimination, elimination and challenge diet phases.
There was a significant statistical association, by chi-square analysis, between food allergy and recurrent serous otitis media in 81/104 patients (78%). The elimination diet led to a significant amelioration of serous otitis media in 70/81 (86%) patients as assessed by clinical evaluation and tympanometry. The challenge diet with the suspected offending food(s) provoked a recurrence of serous otitis media in 66/70 patients (94%).
The possibility of food allergy should be considered in all pediatric patients with recurrent serous otitis media and a diligent search for the putative food allergen made for proper diagnostic and therapeutic intervention.
IgE介导的超敏反应与复发性浆液性中耳炎之间的关系尚未完全明确。
本研究旨在调查复发性浆液性中耳炎患者中食物过敏的患病率。
对104例未经筛选的复发性浆液性中耳炎患者(年龄范围1.5至9岁,平均4.6岁)进行食物过敏评估,采用皮肤点刺试验、特异性IgE检测和食物激发试验。对食物过敏的患者进行为期16周的特定致敏食物排除饮食。对可疑的致敏食物进行非双盲食物激发试验。在排除饮食前、排除饮食期间和激发饮食阶段,通过鼓室图(Welch Allyn Model 23600)监测和评估他们的中耳积液。
通过卡方分析,81/104例患者(78%)的食物过敏与复发性浆液性中耳炎之间存在显著的统计学关联。根据临床评估和鼓室图评估,排除饮食使70/81例(86%)患者的浆液性中耳炎得到显著改善。对66/70例(94%)患者进行可疑致敏食物激发试验后,浆液性中耳炎复发。
所有复发性浆液性中耳炎的儿科患者均应考虑食物过敏的可能性,并应积极寻找可能的食物过敏原,以进行适当的诊断和治疗干预。