Physiopathologic theory linking allergy to increased risk of middle ear inflammation.
Multiple hypotheses may explain the link between allergy and otitis media, even if a definitive mechanism has not been identified.14 The “shock organ” hypothesis speculates that the middle ear may act as a shock organ responding to antigen similar to nasal and bronchial mucosa, according to the unified airway theory hypothesizing that the respiratory tract may behave as one integrated unit. The “Eustachian tube dysfunction” theory speculates that allergy may lead to edema of nasal mucosa, muco-ciliary impairment, and ET ostium blockage, reducing middle ear ventilation and continuous negative pressure, and promoting otitis. Eventually, the most recent hypothesis is that ET dysfunction may be related to chronic inflammation of lymphoid tissues such as adenoids with retrograde aspiration of bacteria and nasopharyngeal secretion into the middle ear cavity.