ALLERGIC EUSTACHIAN-TUBE DYSFUNCTION - DIAGNOSIS AND TREATMENT

Objective: The objective of this study was to describe the characteris tics and response to specific allergy therapy of patients with clinica lly significant eustachian tube dysfunction secondary to allergy. Stud y Design: This was a retrospective case review conducted in the settin g of a private otologic practice (tertiary referral). Patients: The st udy population was composed of 151 patients presenting with eustachian tube dysfunction who had evidence of allergy and had undergone allerg y testing and treatment. The 105 females and 50 males ranged in age fr om 2.8 to 84 years (mean 41.8 +/- 17.3). Interventions: Interventions used included diagnostic allergy testing (inhalants and food) and trea tment with immunotherapy and diet. Main Outcome Measures: The main out come measures were descriptive characteristics and ratings of fullness , allergy symptoms, and well-being rated as ''improved'', ''no change, '' or ''worse.'' Results: All patients had reactivity to inhalants, an d 92.3% were positive to one or more foods. Nearly half of the patient s (49.4%) had undergone at least one advanced test beyond an audiogram as part of their diagnostic evaluation before referral to a tertiary center for treatment. Forty percent had undergone radiological assessm ent. Nearly all had used one or more other treatments without success before allergy therapy. The majority were rated as improved on all thr ee symptoms (fullness 70.9%; allergy symptoms 82.8%; and wellbeing 80. 2%). Adherence to the recommended elimination diet was significantly r elated to outcome. Conclusions: Eustachian tube dysfunction may be due to underlying inhalant and/or food allergies. Even patients with refr actory cases of patulous eustachian tube and eustachian tube obstructi on who have not responded to traditional medical and surgical manageme nt may do well on specific allergy therapy.