Evaluation of the Association Between Allergic Rhinitis and Middle Ear Dysfunction: A Clinicopathological Study

Shaila Sidam; Arshed M P; Ujjawal Khurana; Vikas Gupta; Bhavna Dhingra Bhan

doi:10.7759/cureus.40913

Evaluation of the Association Between Allergic Rhinitis and Middle Ear Dysfunction: A Clinicopathological Study

Cureus. 2023 Jun 24;15(6):e40913. doi: 10.7759/cureus.40913. eCollection 2023 Jun.

Authors

Shaila Sidam¹, Arshed M P², Ujjawal Khurana^{3

3}, Vikas Gupta⁴, Bhavna Dhingra Bhan⁵

Affiliations

¹ Otolaryngology - Head and Neck Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
² Ear Nose Throat, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
³ Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
⁴ Otorhinolaryngology, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
⁵ Paediatrics, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.

Abstract

Introduction: The association between allergic rhinitis and otitis media with effusion (OME) has not yet been well studied in the Indian population. In our study, we have attempted to assess the role of nasal cytology on allergic rhinitis symptomatology and on middle ear dysfunction, and the diagnosis was established by symptomatology, AEC, and a nasal smear for eosinophils.

Material and methods: The present study is a single-centre, hospital-based observational study and was conducted at the Department of Otorhinolaryngology and Head-Neck Surgery (All India Institute of Medical Sciences [AIIMS], Bhopal) among patients with symptoms of allergic rhinitis. The ENT examination included anterior rhinoscopy/diagnostic nasal endoscopy (zero-degree endoscope) along with otoscopy to examine the ear and nose. A nasal smear from the inferior turbinate of the nasal cavity was taken and then examined under a microscope to find out the percentage of eosinophils. The chi-squared test was used for group comparisons of categorical data. Statistical significance was kept at p < 0.05.

Results: In this study, out of 126 subjects with allergic rhinitis, 62 (49.2%) had middle ear dysfunction. The most prevalent middle ear pathologies were eustachian tube dysfunction (ETD; 28 cases, 22%), chronic otitis media (COM [16.6%]), OME (5.5%), and acute otitis media (AOM [4.5%]). ETD made up 45.1% of the ear diseases, with COM (33.87%), OME (11.29%), and AOM (9.6%) following. The mean value of absolute eosinophil count (AEC) among the allergic rhinitis participants (n = 32) was found to be 392.42. Absolute eosinophilia was present in 10 patients out of the 32 subjects being tested. Middle ear pathology was found in 7 of the 10 subjects found positive for absolute eosinophilia. Among the ear pathologies found in the participants (n = 7), the most common were ETD and OME (n = 5).

Conclusion: There was no correlation between nasal smear cytology and the severity of nasal symptoms or middle ear disease. The majority of the participants were in nasal eosinophil grade I and showed sneezing as the most common nasal symptom and COM as the most common middle ear pathologic manifestation.

Keywords: absolute eosinophil count (aec); allergic rhinitis; chronic otitis media; nasal smear; otitis media with effusion.