Yavuz GÜLER, Rukiye GÜLER, Alper ŞEN, Kadir ÖZDAMAR, Esra AYCAN ÜSTYOL

Kronik Otitis Media ve Alerjik Rinit Arasındaki İlişkinin Değerlendirilmesi

Amaç: Bu çalışma alerjik riniti (AR) olan hastaların, kronik süpüratif otitis mediaya (KSOM) yakalanma açısından, sağlıklı bireylere göre daha fazla risk taşıyıp taşımadığını ortaya koymak amacıyla planlanmıştır. Materyal ve Metot: Çalışmaya ikinci basamak bir hastanenin Kulak Burun Boğaz (KBB) polikliniklerine başvuran ve gönüllü olan 676 hasta (402 kadın, 274 erkek) randomize olarak dahil edildi. Tüm gönüllülerin, alerjik rinit için skor (score for allergic rhinitis; SFAR) puanları ve otomikroskopik muayene bulguları kaydedildi. Hastalar alerjik rinit olup olmamasına göre AR (+) ve AR (-) olarak, kronik süpüratif otitis media olup olmamasına göre KSOM (+) ve KSOM (-) olarak gruplandırıldı. İstatistik analizlerin tümü için SPSS 21.0 versiyonu kullanıldı. Bulgular: AR (+) hastaların %18,6’ sı (n=22) KSOM (+) iken, AR (-) hastaların % 28,7’ si (n=160) KSOM (+) idi. Kronik süpüratif otitis media, AR (-) grupta, AR (+) gruba göre anlamlı bir şekilde daha fazla görüldü (p<0,026). Sonuç: Alerjik rinit, kronik süpüratif otitis media etyolojisinde bir risk faktörü olarak görülmemektedir. Tam tersine alerjik rinit etyolojisinde rol oynayan faktörler, kronik süpüratif otitis mediaya karşı koruyucu etki gösteriyor olabilir.

Anahtar Kelimeler:

Alerjik rinit, SFAR, kronik süpüratif otitis media, etyoloji, prevalans

Evaluation of the relationship between chronic otitis media and allergic rhinitis

Aim: This study was planned for the purpose of revealing whether patients with allergic rhinitis (AR) carry a greater risk compared with healthy individuals in terms of developing chronic suppurative otitis media (CSOM).Materyal and Method: 676 volunteer patients (402 female, 274 male) who were referred to the otorhinolaryngology (ENT) outpatient clinics of secondary care hospitals were randomly included in the study. The score for allergic rhinitis (SFAR) points and otomicroscopic examination findings of all the volunteers were recorded. The patients were grouped as AR (+) and AR (-) based on whether they had allergic rhinitis, and as CSOM (+) and CSOM (-) based on whether they had chronic suppurative otitis media. For all statistical analysis, SPSS version 21.0 was used. Results: While 18.6% of the AR (+) patients were KSOM (+), 28.7% of the AR (-) patients were KSOM (+). Chronic suppurative otitis media was seen significantly more in the AR (-) group compared with the AR (+) group (p<0.026). Conclusion: Allergic rhinitis is not seen as a risk factor in the etiology of chronic suppurative otitis media. Conversely, the factors that play a role in the etiology of allergic rhinitis could be effective against chronic suppurative otitis media.

Keywords:

Allergic rhinitis, SFAR, chronic suppurative otitis media, etiology, prevalance,

PDF

___

1. Akyıldız, A.N. : Kulak Hastalıkları ve Mikrocerrahisi. Ankara, Bilimsel Tıp Yayınevi, 1998, pp. 86,337,373.
2. Humaid AH, Ashraf AH, Masood KA, Nuha AH, Saleh AD, Awadh AM. Prevalence and risk factors of Otitis Media with effusion in school children in Qassim Region of SaudiArabia. Int J HealthSci (Qassim). 2014;8(4):325-34.
3. Nemati S, Shakib RJ, Shakiba M, Araghi N, Azimi SZ. Allergic rhinitis in adults with chronic suppurative otitis media. Iranian Journal of Otorhinolaryngology. Jul 2015; 27(4): 261-266.
4. Gorgulu O, Ozelci M, Ozdemir S, Yasar M, Olgun MK, Arikan OK. The role of allergy in the pathogenesis of chronic suppurative otitis media. Journal of International Advanced Otology . 2012, Vol. 8 Issue 2, p276-281. 6p.
5. Knight LC, Eccles R, Morris S. Seasonal allergic rhinitis and its effects on eustachian tube function and middle ear pressure. Clin Otolaryngol Allied Sci. 1992 Aug;17(4):308-12.
6. Bakhshaee M, Rajati M, Fereidouni M, Khadivi E, Varasteh A. Allergic rhinitis and chronic suppurative otitis media. Eur Arch Otorhinolaryngol. 2011 Jan; 268(1):87-91.
7. Fliss DM, Shoham I, Leiberman A, Dagan R. Chronic suppurative otitis media without cholesteatoma in children in southern Israel: incidence and risk factors. Pediatr Infect Dis J. 1991 Dec; 10(12): 895-9.
8. Heo KW, Kim MJ, Lee JH. Impact of nasal conditions on chronic otitis media: a cross-sectional study in Koreans. Acta Otolaryngol. 2018 Feb;138(2):116-121.
9. Park M, Lee JS, Lee JH, Oh SH, Park MK. Prevalence and risk factors of chronicotitis media: the korean national health and nutrition examination survey 2010–2012. PLoS One. 2015 May 15;10(5): e0125905.
10. Kim DH, Han K, Kim SW. Relationship Between Allergic Rhinitis and Mental Health in the General Korean Adult Population. Allergy Asthma Immunol Res. 2016 Jan; 8(1): 49–54.
11. Cingi C, Songu M, Ural A, Annesi-Maesano I, Erdogmus N, Bal C, et al. The Score For Allergic Rhinitis study in Turkey. Am J Rhinol Allergy 2011;25:333-7.
12. Shaheen MM, Nahar S. Comparison of chronic suppurative otitis media in rural and urban primary school children in Bangladesh. J Laryngol Otol. 2014 Jun; 128 (6):499-503.
13. World Health Organization. Chronic suppurative otitis media; burden of illness and management options. Geneva, Switzerland. World Health Organization. 2004; 2-83.
14. Guler Y, Ozdamar K, Erdim İ, Sen A, Guler R. Does breastfeeding protect from allergic rhinitis ?. Praxis of Otorhinolaryngology 2018; 6 (1): 17-21.
15. Steele RW, Suskind-Liu OL. Contemporary Diagnosis and Management of Otitis Media. Newton: Handbooks in Health Care Co.; 2000.
16. De Marco R, Cappa V, Accordini S, Rava M, Antonicelli L, Bortolami O et al. Trends in the prevalence of asthma and allergic rhinitis in Italy between 1991 and 2010. European Respiratory Journal 2012; 39: 883-892.
17. Lack G, Caulfield H, Penagos M. The link between otitis media with effusion and allergy: a potential role for intranasal corticosteroids. Pediatr Allergy Immunol 2011;22(3):258–66.
18. Simpson SA, Lewis R, van der Voort J, Butler CC. Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2011 May 11;(5):CD001935.
19. Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989;299:1259–1260.
20. Robinson DS. Th2 cytokines in allergic disease. Br Med Bull 2000; 56: 956-6.
21. Stirling RG, Chung FK. New immunologic approaches and cytokine targets in asthma and allergy. Eur Respir J 2000; 16: 1158-74.
22. Matricardi PM, Rosmini F, Rapicetta M, Gasbarrini G, Stroffolini T.Atopy, hygiene, and anthroposophic lifestyle. San Marino Study Group. Lancet 1999; 354: 43.