Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation

This review studies the potential relationship between the pathogenesis of allergic rhinitis (AR) and otitis media with effusion (OME) in both adults and children, applying the modified Bradford Hill criteria. While AR and OME are distinct conditions, several epidemiological and experimental studies...

Full description

Saved in:
Bibliographic Details
Main Authors: Ioannis Michael Vlastos, Natalia Tsotsiou, Mohannad Almomani, Maria Doulaptsi, Alexandros Karatzanis, Emmanuel Prokopakis
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Cells
Subjects:
Online Access:https://www.mdpi.com/2073-4409/14/11/805
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850160875942445056
author Ioannis Michael Vlastos
Natalia Tsotsiou
Mohannad Almomani
Maria Doulaptsi
Alexandros Karatzanis
Emmanuel Prokopakis
author_facet Ioannis Michael Vlastos
Natalia Tsotsiou
Mohannad Almomani
Maria Doulaptsi
Alexandros Karatzanis
Emmanuel Prokopakis
author_sort Ioannis Michael Vlastos
collection DOAJ
description This review studies the potential relationship between the pathogenesis of allergic rhinitis (AR) and otitis media with effusion (OME) in both adults and children, applying the modified Bradford Hill criteria. While AR and OME are distinct conditions, several epidemiological and experimental studies suggest a significant association, primarily through allergic mechanisms such as Th-2 immune responses, Eustachian tube dysfunction, and inflammatory mediators in the middle ear. Given the substantial diversity and, in many instances, the “low quality” of related studies when assessed against the standards of modern evidence-based medicine, employing a structured framework like the modified Bradford Hill criteria is beneficial for investigating and establishing causality. This approach, which allows a wide range of diverse studies to be classified as direct, mechanistic, or parallel evidence, supports the notion that management of the allergic immune response may improve OME outcomes, although the inconsistencies among studies require further research. Despite current guidelines recommending against the use of antiallergic medications, the application of the above criteria suggests that proper diagnosis and treatment of allergic rhinitis should be strongly considered in adults and children with OME.
format Article
id doaj-art-dc8de95e2be14c17bccd89f5eca87f98
institution OA Journals
issn 2073-4409
language English
publishDate 2025-05-01
publisher MDPI AG
record_format Article
series Cells
spelling doaj-art-dc8de95e2be14c17bccd89f5eca87f982025-08-20T02:23:01ZengMDPI AGCells2073-44092025-05-01141180510.3390/cells14110805Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for CausationIoannis Michael Vlastos0Natalia Tsotsiou1Mohannad Almomani2Maria Doulaptsi3Alexandros Karatzanis4Emmanuel Prokopakis5Department of Otorhinolaryngology, Evangelismos General Hospital, 10676 Athens, GreeceDepartment of Otorhinolaryngology, Evangelismos General Hospital, 10676 Athens, GreeceDepartment of Otorhinolaryngology, Evangelismos General Hospital, 10676 Athens, GreeceDepartment of Otorhinolaryngology, Heraklion University Hospital, 71500 Crete, GreeceDepartment of Otorhinolaryngology, Heraklion University Hospital, 71500 Crete, GreeceDepartment of Otorhinolaryngology, Heraklion University Hospital, 71500 Crete, GreeceThis review studies the potential relationship between the pathogenesis of allergic rhinitis (AR) and otitis media with effusion (OME) in both adults and children, applying the modified Bradford Hill criteria. While AR and OME are distinct conditions, several epidemiological and experimental studies suggest a significant association, primarily through allergic mechanisms such as Th-2 immune responses, Eustachian tube dysfunction, and inflammatory mediators in the middle ear. Given the substantial diversity and, in many instances, the “low quality” of related studies when assessed against the standards of modern evidence-based medicine, employing a structured framework like the modified Bradford Hill criteria is beneficial for investigating and establishing causality. This approach, which allows a wide range of diverse studies to be classified as direct, mechanistic, or parallel evidence, supports the notion that management of the allergic immune response may improve OME outcomes, although the inconsistencies among studies require further research. Despite current guidelines recommending against the use of antiallergic medications, the application of the above criteria suggests that proper diagnosis and treatment of allergic rhinitis should be strongly considered in adults and children with OME.https://www.mdpi.com/2073-4409/14/11/805allergic rhinitisotitis media with effusionBradford Hill criteriacausation
spellingShingle Ioannis Michael Vlastos
Natalia Tsotsiou
Mohannad Almomani
Maria Doulaptsi
Alexandros Karatzanis
Emmanuel Prokopakis
Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation
Cells
allergic rhinitis
otitis media with effusion
Bradford Hill criteria
causation
title Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation
title_full Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation
title_fullStr Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation
title_full_unstemmed Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation
title_short Is Allergic Rhinitis Related to Otitis Media with Effusion in Adults and Children? Applying Epidemiological Guidelines for Causation
title_sort is allergic rhinitis related to otitis media with effusion in adults and children applying epidemiological guidelines for causation
topic allergic rhinitis
otitis media with effusion
Bradford Hill criteria
causation
url https://www.mdpi.com/2073-4409/14/11/805
work_keys_str_mv AT ioannismichaelvlastos isallergicrhinitisrelatedtootitismediawitheffusioninadultsandchildrenapplyingepidemiologicalguidelinesforcausation
AT nataliatsotsiou isallergicrhinitisrelatedtootitismediawitheffusioninadultsandchildrenapplyingepidemiologicalguidelinesforcausation
AT mohannadalmomani isallergicrhinitisrelatedtootitismediawitheffusioninadultsandchildrenapplyingepidemiologicalguidelinesforcausation
AT mariadoulaptsi isallergicrhinitisrelatedtootitismediawitheffusioninadultsandchildrenapplyingepidemiologicalguidelinesforcausation
AT alexandroskaratzanis isallergicrhinitisrelatedtootitismediawitheffusioninadultsandchildrenapplyingepidemiologicalguidelinesforcausation
AT emmanuelprokopakis isallergicrhinitisrelatedtootitismediawitheffusioninadultsandchildrenapplyingepidemiologicalguidelinesforcausation