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Wise et al.

Page 450

Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE X.G-1.

Evidence for the role of allergic rhinitis in Eustachian tube dysfunction Study Year LOE Study design Study groups Clinical endpoint Conclusion Skoner et al. 1950 1987 1b Double-blind crossover with provocation (histamine) 1 AR (n = 5); 2 Control (n = 5) Inflation-deflation swallow test of ET function All AR subjects had ET obstruction after challenge. Skoner et al. 1949 1986 1b Cohort with intervention (HDM nasal provocation) HDM sensitive AR subjects with normal ET function Inflation-deflation swallow test of ET function 55% of ears developed ET obstruction after provocation. Friedman et al. 1948 1983 1b Double-blind crossover, nasal provocation (pollen insufflation) 8 adult AR subjects with ragweed or Timothy grass allergy Inflation-deflation swallow test of ET function Allergen intranasal challenge induces transient ET obstruction. Osur et al. 1955 1989 2b Cohort Children with AR, ragweed sensitive (n = 15) 9-step ET function test 60% of children developed ET obstruction during ragweed season. Lazo-Saenz et al. 1953 2005 3b Case-control 1 AR (n = 80); 2 Control (n = 50) Tympanometry AR pts had negative pressure. 15% of AR children had type B or C tympanograms. Knight et al. 1954 1992 4 Cohort SAR patients Middle ear pressure on tympanometry, ETD symptoms during pollen season O’Connor et al. 1952 1984 4 Cohort Children with AR (n = 37) Middle ear pressure and nasal airway resistance after pollen challenge

Symptoms or tympanogram evidence of ETD in 24% of subjects. Increased to 48% in pollen season.

69% of children had negative middle ear pressure after challenge.

AR = allergic rhinitis; ET = Eustachian tube; ETD = Eustachian tube dysfunction; HDM = house dust mite; LOE = level of evidence; SAR = seasonal allergic rhinitis.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.