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Allergic otitis media
Medical expert of the article
Last reviewed: 05.07.2025
Allergic diseases in the last 2-3 decades make up the majority of ENT diseases, which is associated with worsening environmental conditions, the appearance of a large number of various artificial food additives in food products, and a general decrease in immunity due to many unfavorable reasons.
At the beginning of the second half of the 20th century, allergic otitis media was identified as an independent form, however, a description of this disease “in its pure form” is practically impossible, since it occurs against a general allergic background and in most cases refers to a systemic inflammatory-allergic process localized in the nasopharynx, auditory tube and tympanic cavity, i.e. in those anatomical formations where an allergotropic substrate is present, i.e. the mucous membrane.
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Causes of Allergic Otitis Media
When studying the pathogenesis of allergic otitis media, two parallel processes are considered - allergic changes in the mucous membrane of the tympanic cavity, reducing its immune properties, and the introduction of an infectious agent into it. Infection can enter the middle ear directly from the auditory tube, lymphogenously and hematogenously from both nearby and distant foci of infection. The interaction and mutual reinforcement of two processes - inflammatory and allergic - gives allergic otitis media some important clinical features. The development of acute allergic otitis media is preceded by allergic edema of the mucous membrane of the auditory tube and tympanic cavity and the appearance of serous secretion and transudate.
Symptoms of Allergic Otitis Media
In allergic otitis media, the typical clinical picture of acute inflammation of the middle ear is not observed. The eardrum is pale, thickened, slightly bulging, the identification contours are smoothed out, the body temperature is normal or slightly subfebrile. The pain syndrome typical for banal acute inflammation of the middle ear is absent. The patient is bothered by ear congestion, noise in it and hearing loss. Ear pain appears only when a secondary inflammatory reaction occurs.
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Diagnosis of allergic otitis media
During paracentesis of the eardrum, viscous mucus containing a large number of eosinophils is released from the tympanic cavity. Similar fluid is found in the cells of the mastoid process. During secondary infection, mucopurulent contents with the presence of polymicrobiota are formed in the tympanic cavity, but the inflammatory process is sluggish, long-term and difficult to treat, resistant to antibiotics. Allergic otitis media occurs in patients with bronchial asthma, with allergic diseases of the upper respiratory tract, in children with diathesis, weakened by childhood infections.
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Treatment of allergic otitis media
Treatment of allergic otitis media is determined by the clinical picture of this form of acute otitis and most often comes down to local procedures against the background of general desensitization of the body. Surgical treatment is resorted to when there is a risk of complications and with a long-term inflammatory process.
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