[Allergic origin of recurrent middle ear effusion and adenoids in young children]

Abstract

Recurrent middle ear effusions and adenoids in children might be caused by mechanical obstruction, infection or allergy. From 1989 to 1990 we examined 35 infants with no history of allergic rhinitis but with recurrent adenoids and middle ear effusions. During operation a skin test was performed for common allergens. Afterwards we tried to identify these allergens by RAST tests on tissue homogenates from the removed adenoids, the middle ear effusion and serum samples. Additionally the IgE levels were determined and the adenoid tissue was examined for eosinophils. In 12 of our 35 children (34%) the skin tests showed an allergy, mostly to different kinds of pollen or house dust. From these positive patients the respective allergens could be determined by RAST tests in serum in 84%, in tissue homogenates from the adenoids in 41% and in the middle ear effusions in 50% of cases. 50% of the children with positive skin tests showed an eosinophilia in the adenoid tissue. We did not find any allergen in the RAST of the infants with negative skin tests. The data show a correlation of allergen specific IgE antibodies in the serum of our patients and in the middle ear and the nasopharynx. Together with an eosinophilia these results suggest an allergic genesis of recurrent middle ear effusions and adenoids in about 20% to 30% of our cases. Early diagnostic procedures to rule out allergy in children with appropriate clinical symptoms are useful, and in positive cases antiallergic treatment is recommended.