Caffarelli C, Cavagni G, Giordano S, Savini E, Piacentini G
Department of Pediatrics, University of Parma, Italy.
Otolaryngol Head Neck Surg. 1996 Nov;115(5):454-7. doi: 10.1177/019459989611500517.
The pathogenesis of otitis media with effusion is still under debate, but allergic sensitization has been suggested in some cases. We investigated whether nasal cytology may indicate an allergic pathogenesis for otitis media with effusion. Atopic symptoms, results of skin prick tests to common aeroallergens, and nasal cytology by nasal scraping were evaluated in 40 children with current otitis media with effusion and compared with findings in a group of 40 healthy children. The presence of nasal eosinophils was significantly more frequent in children with otitis media with effusion than in the control group (p < 0.05). Nasal eosinophils were significantly associated with both allergic rhinitis (p < 0.001) and positive skin prick test results (p < 0.001). Allergic rhinitis with nasal eosinophilia was found in six children of the study group and in one child of the control group (p < 0.05). Our data suggest that nasal allergic inflammation may play a role in a subset of patients with otitis media with effusion. Therefore the possibility of allergic sensitization must always be considered in patients with serous otitis media.
分泌性中耳炎的发病机制仍存在争议,但在某些病例中已提示有过敏致敏现象。我们研究了鼻细胞学检查是否可提示分泌性中耳炎的过敏发病机制。对40例患有分泌性中耳炎的儿童评估了特应性症状、针对常见气传变应原的皮肤点刺试验结果以及通过鼻刮片进行的鼻细胞学检查,并与40例健康儿童组的结果进行比较。分泌性中耳炎患儿中鼻嗜酸性粒细胞的存在明显比对照组更常见(p<0.05)。鼻嗜酸性粒细胞与变应性鼻炎(p<0.001)和皮肤点刺试验阳性结果(p<0.001)均显著相关。研究组的6例儿童和对照组的1例儿童发现有变应性鼻炎伴鼻嗜酸性粒细胞增多(p<0.05)。我们的数据提示鼻过敏炎症可能在一部分分泌性中耳炎患者中起作用。因此,对于浆液性中耳炎患者,必须始终考虑过敏致敏的可能性。