Chapter 10 Otitis media, ocular allergy, and sinusitis
| Autor: | Jay E. Selcow |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
Allergy
medicine.medical_specialty biology business.industry medicine.drug_class medicine.medical_treatment Immunology Antibiotics Amoxicillin Immunoglobulin E medicine.disease Otitis Effusion Internal medicine medicine biology.protein Immunology and Allergy medicine.symptom Tympanostomy tube business Sinusitis medicine.drug |
| Zdroj: | Journal of Allergy and Clinical Immunology. 84:1047-1050 |
| ISSN: | 0091-6749 |
| DOI: | 10.1016/0091-6749(89)90150-4 |
| Popis: | Newer concepts of otitis media support the contention that eustachian tube obstruction (ETO) is an important component of the disease process. Bacterial infection is the best documented cause of otitis media, and antibiotics are the initial therapy of choice. However, chronic otitis media with effusion does not always respond to antibiotics. Studies show that immune reactivity and allergic rhinitis can be risk factors. Seventy percent of patients with acute otitis media, and: 50% of patients with chronic otitis media with effusion have posiive cultures. Predominant organisms are Streptococvs pneumoniae, Haemophilus injknxe, and Brunhrrmella catarrhalis. One third of pa.tients with intranasal rhinovirus infection have eustachian tube dysfunction. Allergy-induced ET0 can be demonstrated by introducing pollen intranasally in sensitive patients; similar responses are also demonstrated with mi,:e-sensitive patients. Despite ET0 after antigen challenge, middle ear effusion has not been demonstrated after nasal challenge. Intranasal histamine provokes ET0 in patients with allergic rhinms but not in normal subjects. Antihistaminedecongestants do not work in otitis media with effusion in patients withoui allergy, but when these were given for ‘7 days to patients allergic to ragweed, eustachian tube function was better than in the placebo group The peak incidence of otitis media from all causes occurs between I and 4 years of age. The drug of choice is amoxicillin; cephalosporin and trimethoprim-sulfamethoxasole are alternatives. For patients with allergic rhinitis and otitis media with effusion, recommended treatment includes antihistamine-decongestants, environmental control measures.. possibly immunotherapy, and intranaaal steroids or cromolyn i:’ necessary. For refractory patients, one must consider tympanostomy tube insertion. Further support of IgE mechanisms in otitis media with effusion is data showing that 23% of patients with IgE-mediated allergy have otitis media with cffusion. Furthermore. the most common abnormality |
| Databáze: | OpenAIRE |
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