Allergy increases susceptibility to otitis media with effusion in a rat model. Second place--Resident Clinical Science Award 1998.

To investigate the possible relationship between allergy and otitis media with effusion (OME), we investigated the hypothesis that allergen presentation to the middle ear causes functional disruption of the eustachian tube predisposing to the development of OME. Thirteen of 19 Brown-Norway rats were sensitized to ovalbumin, and the remaining 6 served as nonallergic controls. To mimic subclinical exposure to allergen, we transtympanically injected ovalbumin at a dose (0.01 mg) that produced no changes detectable by otologic examination. Next, both allergic and nonallergic rats were exposed to transtympanic injection of either low-dose (10 microg/mL) or high-dose (100 microg/mL) lipopolysaccharide to simulate bacterial exposure. The allergic rats were found to have larger middle ear effusions when exposed to high-dose lipopolysaccharide as compared with the nonallergic controls. This response could be inhibited by diphenhydramine. We conclude that allergen presentation to the middle ear of allergic rats causes eustachian tube dysfunction predisposing to OME.