Allergy and secretory otitis media. Clinical and immunologic studies

The relationship of allergy to the etiology of secretory otitis media is very controversial. The authors reexamined the relationship between allergy and secretory otitis media utilizing (1) clinical studies, (2) immunologic analysis of middle ear secretions, and (3) immunohistologic examination of middle ear mucosa. The finding of plasma cells forming IgA, IgM, and IgG in middle ear mucosa and evidence for secretory piece suggest that active protein synthesis does occur in middle ear. The presence of IgE and IgE antibodies in middle ear secretions was low in incidence and when present appeared to be the result of transudation from serum. There was no evidence of active IgE synthesis in this organ. It is concluded that allergy evaluation for children with secretory otitis media is primarly indicated when there is evidence of coexistent atopic symptoms or diathesis.