Although allergic diseases in the upper and lower airways often are viewed and treated as separate diseases and by different specialists, the present view favours a common approach. Allergic rhinitis and asthma have a well documented connection, but studies connecting the middle ear and its diseases to this system are few. Within the birth cohort Environment and Childhood Asthma (ECA) Study in Oslo (1992/1993) we aimed to investigate if secretory otitis media (SOM) at 2 years predispose for asthma, and secondarily for allergic rhinitis or allergic sensitisation development at 10 years.
Subjects and methods
The 459 children from a two year nested case-control study within the birth cohort attending a 10 year follow-up visit, underwent at 2 years parental structured interviews, clinical examinations, lung function measurements and skin prick test (SPT). Doctor diagnosed SOM was reported by parents during the two year interview. At 10 years detailed assessments of clinical examination, interview, lung function measurements, exhaled nitric oxide, bronchial hyperreactivity tests, skin prick tests and immunoglobulin E (IgE) were performed.
Children with SOM had increased risk (odds ratio (OR, 95% (confidence interval)) (1.94 (1.10, 3.40)) of current asthma at 10 years, but this tendency was present already in early life, shown by more recurrent bronchial obstruction (rBO) at two years in children with (38 (50%)) compared to without SOM (109 (29%)) (p<0.001). SOM was however not significantly associated with rhinitis (25% versus 16.5%, in children with compared to without SOM, respectively (p=0.08)) or allergic sensitisation at 10 years (34.2 vs 26.1%, respectively (p=0.15)).
Even though children with SOM had an increased risk for current asthma eight years later, SOM appeared not to predispose for asthma development. The connection between asthma and SOM are likely to represent comorbidities.