What Is the Significance of Rhinitis in Otitis Media with Effusion

Otitis media with effusion (OME) is also termed serous otitis media. It is a condition in which there is fluid (effusion) from the middle ear, but there are no features of acute infection. Whilst OME is often referred to as “glue ear”, this is only appropriate where the fluid has been occurring for a prolonged period and the middle ear contains viscous liquid with the consistency of glue. OME frequently follows an acute middle ear infection, but acute otitis media need not precede the condition, which can also arise if the eustachian tubes are not working. To explain the link between OME and AR, we can posit either a mechanism of local allergy in the respiratory-type epithelium within the middle ear space or an inflammatory response induced by malfunctioning eustachian tubes or conclude that the pathogenesis is currently unknown. One probable pathogenetic mechanism is for the initial event to be the eustachian tube ceasing to function on account of oedema associated with allergic-type inflammation in the respiratory epithelium, followed by secondary inflammation in the ear itself. Allergic disorders (AR, atopic dermatitis and asthma) are more common in individuals with OME. In this chapter, rhinitis and otitis media with effusion are reviewed in all aspects.