Allergy and Otitis Media in Clinical Practice


Purpose of Review

Otitis media (OM) is a disease with very high prevalence in infancy, substantial burden on healthcare resources, and relevant impact on the quality of life of families. The link between OM and allergy is controversial and still debated. However, a fundamental premise has to be placed before introducing this topic: there is the need to use clear and unambiguous terms. Literature abounds with misleading terms that significantly affect the methodology and consequently the outcomes. Moreover, it is essential to differentiate patients according to the OM type (i.e., acute OM, OM with effusion, and chronic suppurative OM), the allergic disease, and mainly the age.

Recent Findings

There are some recent studies exploring this issue through different approaches, such as epidemiological, mechanistic, and therapeutic. To identify allergy as a pathogenic factor for OM could improve the management of OM patients. Vice versa, to suspect allergy in OM patients could be reasonable in selected patients.


The current narrative review provides an overview of the evidence concerning the potential role of allergy in OM. As there are conflicting findings, a possible interpretation of pathophysiological events and a pragmatic approach are proposed.

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Fig. 1


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003;113:1645–57.

    PubMed  Google Scholar 

  2. 2.

    Worall G. Acute otitis media. Can Fam Physician. 2007;53:2147–8.

    Google Scholar 

  3. 3.

    Schilder AGM, Chonmailtree T, Cripps AW, Rosenfeld RM, Casselbrant ML, Haggard MP, et al. Otitis media. Nature Revies Dis Primers. 2016;2:1–18.

    Google Scholar 

  4. 4.

    Torretta S, Marchisio P. Otitis media in children: a proposal for a new nosological classification. Int J Pediatr Otorhinolaryngol. 2017;93:174–5.

    PubMed  Google Scholar 

  5. 5.

    Homoe P, Kvaerner K, Casey JR, Damoisseaux RAMJ, van Dongen TMA, Gunasekera H, et al. Panel I: epidemiology and diagnosis. Otolaryngol Head Neck Surg. 2017;156(4S):S1–S21.

    PubMed  Google Scholar 

  6. 6.

    Venekamp RP, Damoiseaux RAMJ. Acute otitis media in children. Am Fam Physician. 2017;95:109–10.

    PubMed  Google Scholar 

  7. 7.

    Shirai N, Preciado D. Otitis media: what is new? Curr Opin Otolaryngol Head Neck Surg. 2019;27:495–8.

    PubMed  Google Scholar 

  8. 8.

    Danishyar A, Ashurst JV Acute otitis media. StatPearls Publishing 2020.

  9. 9.

    Siegel RM. Acute otitis media guidelines, antibiotic use, and shared medical decision-making. Pediatrics. 2010;125:384–8.

    PubMed  Google Scholar 

  10. 10.

    Schilder AG, Marom T, Bhutta MF. Panel 7: otitis media: treatment and complications. Otolaryngol Head Neck Surg. 2017;19(Suppl 1):S2–8.

    Google Scholar 

  11. 11.

    Bluestone CD, Klein JO. Definitions, terminology, and classification. In: “Otitis media in infants and children”. Forth Edition. BC Decker Inc 2007:1–19

  12. 12.

    • Marchisio P, Bortone B, Ciarcià M, Motisi MA, Torretta S, Castelli Gattinara G, et al. Updated guidelines for the management of acute otitis media in children by the Italian Society of Pediatrics. Pediatr Infect Dis J. 2019;38:S22–36 Up-to-date guidelines on the management of otitis media acuta.

    PubMed  Google Scholar 

  13. 13.

    Kaur R, Morris M, Pichichero ME. Epidemiology of acute otitis media in the postpneumococcical conjugate vaccine era. Pediatrics. 2017;140:e20170181.

    PubMed  PubMed Central  Google Scholar 

  14. 14.

    •• Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, et al. Clinical practice guidelines: otitis media with effusion (update). Otolaryngol Head Neck Surg. 2016;154:S1–S41 Excellent guidelines on OME.

    PubMed  Google Scholar 

  15. 15.

    Mandel EM, Doyle WJ, Winther B, Alper CM. The incidence, prevalence and burden of OM in unselected children aged 1-8 years followed by weekly otoscopy through the “common cold” season. Int J Pediatr Othorhinolaryngol. 2008;72:491–9.

    Google Scholar 

  16. 16.

    Bennett KE, Haggard MP, Silva PA, Steward IA. Behaviour and development effects of otitis media complications in young children. Clin Infect Dis. 2008;46:815–23.

    Google Scholar 

  17. 17.

    Claessen JQ, Appelman CL, Touw-Otten FW, Hordijk GJ, de Melker RA. Persistence of middle ear dysfunction after recurrent acute otitis media. Clin Otolaryngol Allied Sci. 1994;19:35–40.

    CAS  PubMed  Google Scholar 

  18. 18.

    Alho O, Oja H, Koivu M, Sorri M. Risk factors for chronic otitis media with effusion in infancy. Each otitis media episode induces a high but transient risk. Arch Otolaryngol Head Neck Surg. 1995;121:839–43.

    CAS  PubMed  Google Scholar 

  19. 19.

    Verhoeff M, van der Veen EL, Rovers MM, Sanders EAM, Schilder AGM. Chronic suppurative otitis media: a review. Int J Pediatr Otorhinolaryngol. 2006;70:1–12.

    PubMed  Google Scholar 

  20. 20.

    Monasta L. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One. 2012;7:e36226.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. 21.

    • Licari A, Castagnoli R, Brambilla I, Marseglia A, Tosca MA, Mareseglia GL, et al. Asthma endotyping and biomarkers in childhood asthma. Pediatr Allergy Immunol Pulmonol. 2018;31:44–55 Excellent review on the workup of asthmatic children.

    PubMed  PubMed Central  Google Scholar 

  22. 22.

    Johansson SGO, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, et al. Revised nomenclature for allergy for global use: report of the nomenclature review committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004;113:832–6.

    CAS  PubMed  Google Scholar 

  23. 23.

    Ciprandi G, Tosca MA, Silvestri M, Ricciardolo FLM. Inflammatory biomarkers for asthma endotyping and personalized therapy. Expert Rev Clin Immunol. 2017;13:715–21.

    CAS  PubMed  Google Scholar 

  24. 24.

    Scadding GK, Kariyawasan HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (revised edition 2017; first edition 2007). Clin Exp Allergy. 2017;47:856–89.

    CAS  Google Scholar 

  25. 25.

    •• Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, et al. International consensus statement on allergy and rhinology: allergic rhinitis. Int Forum Allergy Rhinol. 2018;8:108–352 Excellent review on allergic rhinitis.

    PubMed  PubMed Central  Google Scholar 

  26. 26.

    • Orlandi RR, Kingdom TT, Hwang PH, Smith TL, Alt JA, Barrody FM, et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol. 2016;6:S22–S209 Exhaustive review on rhinosinusitis.

    PubMed  Google Scholar 

  27. 27.

    Raymond HJD, Schmidt T, Fulghum RS, Ruckriegal L. Otitis media: a problem for the physical anthropologist. Y Phys Antropol. 1988;31:143–67.

    Google Scholar 

  28. 28.

    Roditi RE, Veling M, Shin JJ. Age: an effect modifier of the association between allergic rhinitis and otitis media with effusion. Laryngoscope. 2016;126:1687–92.

    PubMed  Google Scholar 

  29. 29.

    Gelardi M, Marchisio P, Caimmi D, Incorvaia C, Albertario G, Bianchini S, et al. Pathophysiology, favoring factors, and associated disorders in otorhinosinusology. Pediatr Allergy Immunol. 2012;23(Suppl. 22):5–16.

    Google Scholar 

  30. 30.

    Zhang Y, Xu M, Zhang J, Zen L, Wang L, Zheng QY. Risk factors for chronic and recurrent otitis media – a meta-analysis. PLoS One. 2014;9:e86397.

    PubMed  PubMed Central  Google Scholar 

  31. 31.

    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;22:258–66.

    PubMed  Google Scholar 

  32. 32.

    Oh J-H, Kim WJ. Interaction between allergy and middle ear infection. Curr Allergy Asthma Rep. 2016;16:66.

    PubMed  Google Scholar 

  33. 33.

    Annunziato F, Romagnani C, Romagnani C. The 3 major types of innate and adaptive cell-mediated effector immunity. J Allergy Clin Immunol. 2015;135:626–35.

    CAS  Google Scholar 

  34. 34.

    An Y-F, Wu Y-J, Zeng X-H, Song L-J, Ma F, Liao W-J, et al. B cell lymphoma-2-like protein-12 association with T-helper 2 inflammation in chronic rhinosinusitis with allergy. Int Forum Allergy Rhinol. 2018;8:1300–7.

    PubMed  Google Scholar 

  35. 35.

    Ciprandi G, Marseglia GL, Klersy C, Tosca MA. Relationships between allergic inflammation and nasal airflow in children with persistent allergic rhinitis due to mite sensitization. Allergy. 2005;60:957–60.

    CAS  PubMed  Google Scholar 

  36. 36.

    Ciprandi G, Pronzato C, Ricca V, Bagnasco M, Canonica GW. Evidence of intercellular adhesion molecule-1 expression on nasal epithelial cells in acute rhinoconjunctivitis caused by pollen exposure. J Allergy Clin Immunol. 1994;94:738–46.

    CAS  PubMed  Google Scholar 

  37. 37.

    Salpietro C, Rigoli L, Miraglia del Giudice M, Cuppari C, Di Bella C, Salpietro AM, et al. TLR2 and TLR4 gene polymorphisms and atopic dermatitis in Italian children: a multicenter study. Int J Immunopathol Pharmacol. 2011;24:33–40.

    CAS  PubMed  Google Scholar 

  38. 38.

    Cirillo I, Marseglia GL, Klersy C, Ciprandi G. Allergic patients have more numerous and prolonged respiratory infections than non-allergic subjects. Allergy. 2007;62(9):1087–90.

    CAS  PubMed  Google Scholar 

  39. 39.

    Daniel M, Imtiaz-Umer S, Fergie N, Birchall JP, Bayston R. Bacterial involvement in otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2012;76:1416–22.

    CAS  PubMed  Google Scholar 

  40. 40.

    Torretta S, Pignataro L, Carioli D, Ibba T, Folino F, Rosazza C, et al. Phenotype profiling and allergy in otitis-prone children. Front Pediatr. 2018;6:383.

    PubMed  PubMed Central  Google Scholar 

  41. 41.

    Marseglia GL, Poddighe D, Caimmi D, Ciprandi G. Role of adenoids and adenoiditis in children with allergy and otitis media. Curr Allergy Asthma Rep. 2009;9:460–4.

    PubMed  Google Scholar 

  42. 42.

    Bhutta MF. Epidemiology and pathogenesis of otitis media: construction of a phenotype landscape. Audiol Neurotol. 2014;19:210–23.

    Google Scholar 

  43. 43.

    Coleman C, Moore M. Decongestants and antihistamines for acute otitis media in children. Cochrane Databse Syst Rev. 2011;3:CD001727.

    Google Scholar 

  44. 44.

    Daud MK, Shahrjerdi B, Ramli RR, Rahman NA. The association of allergy and chronic suppurative otitis media: a study in a tropical country. Med J Malaysia. 2019;74:205–8.

    Google Scholar 

  45. 45.

    Lasisi OA, Arinola OG, Olayemi O. Role of elevated immunoglobulin E levels in suppurative otitis media. Ann Trop Paediatr. 2008;28:123–7.

    PubMed  Google Scholar 

  46. 46.

    Lanphear BP, Byrd RS, Auinger P, Hall CB. Increasing prevalence of recurrent otitis media among children in the United States. Pediatrics. 1997;99:E1.

    CAS  PubMed  Google Scholar 

  47. 47.

    Bakhshaee M, Rajati M, Fereidouni M, Khadivi E, Varasteh A. Allergic rhinitis and chronic suppurative otitis media. Eur Arch Otorhinolaryngol. 2011;268:87–91.

    PubMed  Google Scholar 

  48. 48.

    Fireman P. Otitis media and eustachian tube dysfunction: connection to allergic rhinitis. J Allergy Clin Immunol. 1997;99:S787–97.

    CAS  PubMed  Google Scholar 

  49. 49.

    Mogi G, Suzuki M. The role of IgE-mediated immunity in otitis media: fact of fiction? Annals NY Acad Sci. 1997;830:61–9.

    CAS  Google Scholar 

  50. 50.

    Skoner DP. Complications of allergic rhinitis. J Allergy Clin Immunol. 2000;105:S605–9.

    CAS  PubMed  Google Scholar 

  51. 51.

    Bluestone CD. Studies in otitis media: Children’s Hospital of Pittsburg-University of Pittsburg progress report – 2004. Larungoscope. 2004;114(Suppl. 105):1–26.

    Google Scholar 

  52. 52.

    Tewfik TL, Mazer B. The links between allergy and otitis media with effusion. Curr Opin Otolaryngol Head Neck Surg. 2006;14:187–90.

    PubMed  Google Scholar 

  53. 53.

    Caruso G, Damiani V, Salerni L, Passali FM. Atopy:pediatric ENT manifestations in children. Int J Pediatr Otorhinolaryngol. 2009;73S:S19–25.

    Google Scholar 

  54. 54.

    Kubba H, Pearson JP, Birchall JP. The aetiology of otitis media with effusion: a review. Clin Otolaryngol. 2000;25:181–94.

    CAS  PubMed  Google Scholar 

  55. 55.

    MacIntyre EA, Heinrich J. Otitis media in infancy and the development of asthma and atopic disease. Curr Allergy Asthma Rep. 2012;12:547–50.

    CAS  PubMed  Google Scholar 

  56. 56.

    Dewey C, Midgeley E, Maw R. The relationship between otitis media with effusion and contact with other children in a British cohort studied from 8 months to 3 ½ years. The ALSPAC study team. Avon longitudinal study of pregnancy and childhood. Int J Pediatr Otorhinolaryngol. 2000;55:33–45.

    CAS  PubMed  Google Scholar 

  57. 57.

    Caffarelli C, Savini E, Giordano S, Gianlupi G, Cavagni G. Atopy in children with otitis media with effusion. Clin Exp Allergy. 1998;28:591–6.

    CAS  Google Scholar 

  58. 58.

    Alles R, Parikh A, Hawk L, Darby Y, Navas Romero J, Scadding G. The prevalence of atopic disorders in children with chronic otitis media with effusion. Pediatr Allergy Immunol. 2001;12:102–6.

    CAS  PubMed  Google Scholar 

  59. 59.

    Marseglia GL, Pagella F, Caimmi D, Caimmi S, Castellazzi AM, Poddighe D, et al. Increased risk of otitis media with effusion in allergic children presenting with adenoiditis. Otolaryngol Head Neck Surg. 2008;138:572–5.

    PubMed  Google Scholar 

  60. 60.

    Martines F, Martines E, Sciacca V, Bentivegna D. Otitis media with effusion with or without atopy: audiological findings on primary schoolchildren. Am J Otolaringol Head Neck Med Surg. 2011;32:601–6.

    Google Scholar 

  61. 61.

    Martines F, Bentivegna D, Maira E, Sciacca V, Martines E. Risk factors for otitis media with effusion: case-control study in Sicilian schoolchildren. Int J Pediatr Otorhinolaryngol. 2011;75:754–9.

    CAS  PubMed  Google Scholar 

  62. 62.

    Kreiner-Moller E, Chawes BLK, Caye-Thomasen P, Bonnelykke K, Bisgaard H. Allergic rhinitis is associated with otitis media with effusion: a birth cohort study. Clin Exp Allergy. 2012;42:1615–20.

    CAS  PubMed  Google Scholar 

  63. 63.

    Ibanez MD, Valero AV, Montoro J, Jauregui I, Ferrer M, Davila I, et al. Analysis of comorbidities and therapeutic approach for allergic rhinitis in a paediatric population in Spain. Pediatr Allergy Immunol. 2013;24:678–84.

    PubMed  Google Scholar 

  64. 64.

    Kwon C, Lee HY, Kim MG, Boo SH, Yeo SG. Allergic disease in children with otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2013;77:158–61.

    PubMed  Google Scholar 

  65. 65.

    Hurst DS. Association of otitis media with effusion and allergy as demonstrated by intradermal skin testing and eosinophil cationic protein levels in both middle ear effusions and mucosal biopsies. Laryngoscope. 1998;106:1128–37.

    Google Scholar 

  66. 66.

    Hurst DS, Amin K, Seveus L, Venge P. Evidence of mast cell activity in the middle ears of children with otitis media with effusion. Laryngoscope. 1999;109:471–7.

    CAS  Google Scholar 

  67. 67.

    Hurst DS, Venge P. Evidence of eosinophil, neutrophil, and mast cell mediators in the effusion of OME patients with and without atopy. Allergy. 2000;55:435–41.

    CAS  PubMed  Google Scholar 

  68. 68.

    Iino Y, Nagamine T, Yabe T, Matsutani S. Eosinophils are activated in middle ear mucosa and middle ear effusion of patients with intractable otitis media associated with bronchial asthma. Clin Exp Allergy. 2001;31:1135–43.

    CAS  PubMed  Google Scholar 

  69. 69.

    Sobol SE, Taha R, Schloss MD, Mazer BD, Manoukian JJ, Tewfik TL, et al. Th2 cytokine expression in atopic children with otitis media with effusion. J Allergy Clin Immunol. 2002;110:125–30.

    CAS  PubMed  Google Scholar 

  70. 70.

    Nguyen LH, Manoukian JJ, Sobol SE, Tewfik TL, Mazer BD, Schloss MD, et al. Similar allergic inflammation in the middle ear and the upper airway: evidence linking otitis media with effusion to the united airways concept. J Allergy Clin Immunol. 2004;114:1110–5.

    Google Scholar 

  71. 71.

    Ebmeyer J, Furukawa M, Pak K, Ebmeyer U, Sudhoff H, Broide D, et al. Role of mast cells in otitis media. J Allergy Clin Immunol. 2005;116:1129–35.

    CAS  PubMed  Google Scholar 

  72. 72.

    Iino Y, Kakizaki K, Katano H, Saigusa H, Kanegasaki S. Eosinophil chemoattractants in the middle ear of patients with eosinophilic otitis media. Clin Exp Allergy. 2005;35:1370–6.

    CAS  PubMed  Google Scholar 

  73. 73.

    Passali D, Passali GC, Lauriello M, Romano A, Bellussi L, Passali FM. Nasal allergy and otitis media. A real correlation? Sultan Qaboos Univ Med J. 2014;14:e59–64.

    PubMed  PubMed Central  Google Scholar 

  74. 74.

    Goodrich T, Rubio F, Cutler JL. Otitis media and antihistamines. Curr Allergy Asthma Rep. 2009;9:456–9.

    CAS  PubMed  Google Scholar 

  75. 75.

    Flynn GG. Antihistamines and/or decongestants for otitis media effusion (OME) in children (Review). Cochrane Database Syst Rev. 2011;2011(9):CD003423.

    Google Scholar 

  76. 76.

    Ertugay CK, Cingi C, Yaz A, San A, Ulusoy S, Erdogmus N, et al. Effect of combination of montelukast and levocetirizine on otitis media with effusion: a prospective, placebo-controlled trial. Acta Otolaryngol. 2013;133:1266–72.

    CAS  PubMed  Google Scholar 

  77. 77.

    Bonney AG, Goldman RD. Antihistamines for children with otitis media. Can Fam Physician. 2014;60:43–6.

    PubMed  PubMed Central  Google Scholar 

  78. 78.

    Prince AA, Rosenfeld RM, Shin JJ. Antihistamine use for otitis media with effusion: ongoing opportunities for quality improvement. Otolaryngol Head Neck Surg. 2015;153:935–42.

    PubMed  Google Scholar 

  79. 79.

    Principi N, Marchisio P, Esposito S. Otitis media with effusion: benefits and harms of strategies in use for treatment and prevention. Expert Rev Anti-Infect Ther. 2016;14:415–23.

    CAS  PubMed  Google Scholar 

  80. 80.

    Roditi RE, Rosenfeld RM, Shin JJ. Otitis media with effusion: our national practice. Otolaryngol Head Neck Surg. 2017;157:171–2.

    PubMed  Google Scholar 

  81. 81.

    • Simon F, Haggard M, Rosenfeld RM, Jia H, Peer S, Calmels MN, et al. International consensus (ICON) on management of otitis media with effusion in children. Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135(135):S33–9 Useful review with practical information.

    CAS  PubMed  Google Scholar 

  82. 82.

    Vanneste P, Page C. Otitis media with effusion in children: pathophysiology, diagnosis, and treatment. A review. J Otology. 2019;14:33–9.

    Google Scholar 

  83. 83.

    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 (Review). Cochrane Database Syst Rev 2011, (5): CD001935.

  84. 84.

    Roditi RE, Caradonna DS, Shin JJ. The proposed usage of intranasal steroids and antihistamines for otitis media with effusion. Curr Allergy Asthma Rep. 2019;19:47.

    PubMed  Google Scholar 

  85. 85.

    Pfaar O, Angier E, Muraro A, Halken S, Roberts G. R1: algorithms in allergen immunotherapy in allergic rhinoconjunctivitis. Allergy 2020 (in press).

  86. 86.

    Hurst DS. Efficacy of allergy immunotherapy as a treatment for patients with chronic otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2008;72:1215–23.

    PubMed  Google Scholar 

  87. 87.

    Llewellyn A, Norman G, Harden M, Coatesworth A, Kimberling D, Schilder A, et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Health Technol Assess. 2014;18:1–180.

    PubMed  PubMed Central  Google Scholar 

  88. 88.

    McCoul ED, Weinreich HM, Mulder H, Man L-X, Schulz K, Shin JJ. Health care utilization and prescribing patterns for adult Eustachian tube dysfunction. Otolaryngol Head Neck Surg. 2019;160:1071–80.

    PubMed  Google Scholar 

  89. 89.

    Cheng X, Sheng H, Ma R, Gao Z, Han Z, Chi F, et al. Allergic rhinitis and allergy are risk factors for otitis media with effusion: a meta-analysis. Allergol Immunopathol. 2017;45:25–32.

    CAS  Google Scholar 

  90. 90.

    • Zernotti ME, Pawankar R, Ansotegui I, Badellino H, Croce JS, Hossny E, et al. Otitis media with effusion and atopy: is there a causal relationship? World Allergy Org J. 2017;10:37 Exhaustive review on otitis media and allergy.

    Google Scholar 

  91. 91.

    Byeon H. The association between allergic rhinitis and otitis media: a national representative sample of in south Korean children. Sci Rep. 2019;9:1610.

    PubMed  PubMed Central  Google Scholar 

  92. 92.

    Sharifian MR, Mahmoudi M, Pourmomenarabi B, Keramati MR. Correlation between allergic rhinitis and otitis media with effusion. Iran J Otorhinolaryngol. 2019;31:105.

    Google Scholar 

  93. 93.

    Juszczak H, Aubin-Pouliot AA, Sharon JD, Loftus PA. Sinonasal risk factors for eustachian tube dysfunction: cross-sectional findings from NHANES 2011-2012. Int Forum Allergy Rhinol. 2019;9:466–72.

    PubMed  Google Scholar 

  94. 94.

    Saifudin N, Husain S, Goh BS. Prevalence of allergic rhinitis in children with otitis media with effusion. Eur Ann Allergy Clin Immunol. 2020;52(3):121–30 (in press).

    Google Scholar 

  95. 95.

    Ameli F, Tosca MA, Licari A, Gallo F, Ciprandi G. Can an otorhinolaryngological visit induce the suspect of allergic rhinitis in children? Eur Ann Allergy Clin Immunol. 2019;51:281–9.

    Google Scholar 

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Ciprandi, G., Torretta, S., Marseglia, G.L. et al. Allergy and Otitis Media in Clinical Practice. Curr Allergy Asthma Rep 20, 33 (2020).

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  • Acute otitis media
  • Allergy
  • Otitis media with effusion
  • Infections
  • Risk factors
  • Type 2 inflammation