Management of Complications in 1452 Pediatric and Adult Cochlear Implantations.

OBJECTIVE: The aim of this study was to determine the short- and long-term complications after cochlear implantation (CI) procedures and to discuss the management and prevention of these complications. METHODS: The study included a total of 1452 pediatric and adult cochlear implantation procedures performed in our clinic from March 2000 through September 2019. Of the 1452 implantations, 1201 were performed in children and 156 in adults. The minimum follow-up period was three months and maximum was 19 years. The mean age of the patients was 6.7±3.9 years (range, 10 months-69 years) at the time of their respective procedures. Complications were classified as major complications requiring reimplantation, major complications not requiring reimplantation and minor complications. All postoperative complications and treatment methods were examined. RESULTS: A total of 148 (10.1%) complications were observed in the 1452 cochlear implants. Of these, 69 (4.75%) were major and 79 (5.44%) were minor complications. While 40 (2.75%) of the major complications required reimplantation, 29 (1.99%) did not. The most common cause of major complications leading to reimplantation was device failure (29 patients, 1.99%). The most common cause of minor complications was hematoma (21 patients). Total complication rates (6.68%) were significantly higher in children than in adults (3.51%) (p=0.00). CONCLUSION: Our 19 years of clinical experience has shown that CI is a successful and safe procedure that can be performed with low major complication rates. It is important to know the possible complications and to manage them correctly.

The Role of Mobile Phone Camera Recordings in the Diagnosis of Meniere's Disease and Pathophysiological Implications.

OBJECTIVES: This study aimed to understand if videos of the patients' nystagmus recorded by themselves during the attacks can help in the diagnosis of Meniere's disease (MD). MATERIALS AND METHODS: Sixty patients (age range 32-78 years) who had vestibular attacks and hearing complaints admitted to Çukurova University Hospital Otolaryngology Department and a private office between September 2013 and January 2017 were included in this randomized clinical trial study. Two groups with 30 patients each were formed. The first group was asked to send eye-videos recorded during the attack, while the patients in the second group were followed with conventional methods. Twenty-six patients in the first group were able to send satisfactory eye movement videos; four patients were excluded due to repeated recording faults. Twenty-seven patients in the second group could be followed; three patients were lost to follow-up. The number of attacks and time needed to diagnose both groups were compared. RESULTS: The video group could be diagnosed in a shorter period compared to the control group. The diagnosis was made within two attacks (38 days) in the video group and within four attacks (92 days) in the control group. CONCLUSION: This study shows that cell phone camera recordings of nystagmus of the patients are very helpful to diagnose MD. These recordings can also be used as an adjunct to understand the pathophysiology of the disease.

The Utility of Endoscope-Assisted Rigid Bronchoscopy in Pediatric Airway Foreign Body Removals.

INTRODUCTION: Aspiration of foreign bodies is an emergency condition in children and may result in death, especially in children under 3 years of age. Therefore, diagnosis and treatment must be made rapidly. OBJECTIVE: This study sought to summarize our experience with endoscope-assisted rigid bronchoscopy (RB) in the diagnosis and treatment of pediatric tracheobronchial foreign body emergencies to reduce complications and mortality. METHODS: This was a retrospective cross-sectional study. The medical records of 337 children diagnosed with clinically suspected airway foreign body aspiration in the pediatric emergency department were analyzed retrospectively. The patients were divided into 2 groups with endoscopy used during RB in group 1 whereas group 2 was RB only. The surgeons who performed the bronchoscopies completed a survey on the advantages/disadvantages of these 2 procedures. RESULTS: All of the patients had a positive history of suspected foreign body aspiration and foreign bodies were identified in 77.1% of the patients during RB. There were 161 (47.8%) patients in group 1 and 176 (52.2%) patients in group 2. In group 2, 5 patients showed transient hypoxia, and 6 patients had an episode of transient bleeding during the operations. These numbers were 3 and 3, respectively, in group 1. One patient in group 2 suffered cardiac arrest and died during surgery. The authors did not see any long-term complications after these operations and the authors did not find any statistically significant differences between the groups for complication rates. CONCLUSION: The RB is the gold standard procedure for removal of pediatric airway foreign bodies. The survey used in this study and our extensive experience have shown that the distal bronchi and foreign bodies can be visualized more effectively when using a rigid endoscope during RB, especially in children under the age of 3 years. In order to improve the safety of the surgical procedure, the authors propose that endoscope-assisted RB should be used in emergencies concerning foreign bodies in the airways of children.

Cochlear Implantation Outcomes in Children with Agenesis of the Corpus Callosum: A Retrospective Study and A Review of the Literature.

OBJECTIVES: The aim of the present study was to analyze the outcomes of cochlear implantation (CI) in patients with agenesis of the corpus callosum (CCA). A literature review and a retrospective analysis of our cochlear implant database were performed. MATERIALS AND METHODS: To the best of our knowledge, in the English literature, there was only one case reported with CCA who had undergone CI surgery. This case had Donnai-Barrow syndrome. In the Cukurova University School of Medicine Department of Otorhinolaryngology database, 5 of the 1317 patients who underwent CI surgery who had CCA were selected. The patients' demographic characteristics, operative findings, surgical outcomes, and additional disabilities were investigated. The patients' preoperative and postoperative Listening Progress Profile (LiP) and Meaningful Auditory Integration Scale (MAIS) tests were done to analyze the auditory performances. RESULTS: The participants of the study were 5 (0.38%) individuals (2 male and 3 female patients; ages 5.5, 7.5, 8, 9, and 12 years). Two of the patients had total agenesis, and the other three had partial agenesis of the CCA. In the histories of the patients, one patient had parental consanguinity, and one had febrile convulsion. No patient had an additional disability. None had experienced device failure. No patients were non-users or limited users of cochlear implants. Postoperative LiP and MAIS test scores were improved for all patients nearly as the patients without any deformity. They showed normal auditory performance in the analysis in their postoperative 48 months of follow-up. CONCLUSION: Patients who had CCA are good candidates for CI surgery.

How does cochlear implantation affect five vestibular end-organ functions and dizziness?

OBJECTIVE: To evaluate all five vestibular end-organ functions (lateral, anterior, posterior semicircular canal, utricule, and saccule) and to investigate the relationship between Dizziness Handicap Inventory (DHI) and vestibular functions prior to CI (cochlear implantation) and at postoperative day 3 and month 3. METHODS: A total of 42 patients (age 16-70years) with normal vestibular functions preoperatively and undergoing unilateral CI were included in this prospective descriptive study. Video head impulse test (vHIT) for three semicircular canal (SSC) functions, ocular vestibular-evoked myogenic potential (oVEMP) for utricule function, cervical vestibular-evoked myogenic potential (cVEMP) for saccule function and DHI for subjective vertigo symptoms were performed prior to CI and at postoperative day 3 and month 3. RESULTS: There was a significant impairment of vestibular function in 12 patients (28.5%) on the implantation side and significant DHI increase was observed in 13 of 42 (30.9%) patients at postoperative day 3 after CI (p<0.05). We found SSC dysfunction in 7 patients (16,6%) who underwent observation with vHIT, saccule dysfunction in 8 patients (19%) with cVEMP and utricule dysfunction in 5 patients (11.9%) with oVEMP on the operated side 3days after surgery (p<0.05). Posterior SSC functions (5 patients) were more affected than lateral SSC functions (3 patients). At postoperative month 3, six patients (14.2%) still had deteriorating results in the objective tests and significant DHI increase was continued in 4 (9.5%) patients (p<0.05). The deterioration in vHIT continued in only 1 (2.3%) patient (p>0.05). The deterioration in cVEMP continued in 5 (11.9%) patients (p<0.05). The deterioration in oVEMP continued in 2 (4.7%) patients (p>0.05). There was a significant correlation between DHI and objective vestibular tests both in the early and late postoperative period (r=0.795; p<0.05). CONCLUSION: Our study showed that both canal and otolith functions can be damaged after CI especially in the early postoperative period. Surprisingly, posterior SSC functions were more affected than lateral SSC. Therefore, a gold standard vestibular test battery that can evaluate each of three SSC canals and two otoliths functions is essential. Since a single vestibular test for this purpose is not available, we recommend the use of the three available vestibular tests together. This test battery, which is capable of evaluating five vestibular end-organ functions in preoperative and postoperative vestibular evaluations, can provide more accurate results not only for CI but also for most otologic surgeries.

Intratympanic Methylprednisolone versus Dexamethasone for the Primary Treatment of Idiopathic Sudden Sensorineural Hearing Loss.

OBJECTIVES: The aim of the present study was to compare the therapeutic effectiveness of intratympanic (IT) methylprednisolone and dexamethasone in the initial treatment of patients with idiopathic sudden sensorineural hearing loss (ISSHL). MATERIALS AND METHODS: A total of 46 patients with ISSHL who had been treated with IT methylprednisolone or dexamethasone were included in the present study. Dexamethasone (4 mg/mL) and methylprednisolone (20 mg/mL) were given transtympanically to 22 and 24 patients, respectively, one dosage per day for 5 consecutive days. Audiologic evaluations were performed pretreatment, daily in inpatient clinics, and in the first week and second month after discharge, using four-frequency pure-tone average (PTA) and speech discrimination score (SDS). Audiologic improvement was classified according to the Furuhashi criteria. RESULTS: According to the Furuhashi criteria, the therapeutic success rate was 62.5% (complete improvement 16.7% and marked improvement 45.8%) in the methylprednisolone group, whereas it was 54.6% (complete improvement 27.3% and marked improvement 27.3%) in the dexamethasone group. Therapeutic success was higher in the methylprednisolone group; however, it was not statistically significant. When the audiologic improvement was accepted as >10 dB in PTA, the therapeutic success rates were 83.3% in the methylprednisolone group and 72.8% in the dexamethasone group. The mean (±SD) improvement of PTA before and after treatment was 30.8±21.4 in the methylprednisolone group and 24.7±2.5 in the dexamethasone group. The mean improvement in SDS was 32.6±25 in the methylprednisolone group and 23.7±26.9 in the dexamethasone group. CONCLUSION: IT steroids are safe, effective, and well-tolerated agents in the initial treatment of patients with ISSHL. Despite having different pharmacokinetic characteristics, IT methylprednisolone and dexamethasone have no superiorities over each other in the primary treatment in patients with ISSHL.

The Effectiveness of Botulinum Toxin Type A Injections in the Management of Sialorrhea.

OBJECTIVE: The aim of this study was to evaluate the effect of Botulinum toxin type A by injecting in the submandibular and parotid glands on the frequency and severity of sialorrhea. METHODS: Pediatric patients who were referred to our department with sialorrhea were evaluated using their parents' frequency and severity scores of sialorrhea with visual analog scales before and after 3 months of botulinum toxin type A injections. Bilateral submandibular and parotid glands were injected with Botulinum toxin type A. RESULTS: Twenty-seven pediatric patients who were referred to our department with a complaint of sialorrhea were included in this study. Seventeen patients were female and 10 were male. Severe sialorrhea with cerebral palsy was present in all the patients. There were no complications after the procedure. CONCLUSION: Botulinum toxin A injected in the major salivary glands in pediatric patients with neurological disorders is a safe and effective method.

Squamous Cell Carcinoma With Hyper-IgE Syndrome: A Case Report.

BACKGROUND: Hyper-immunoglobulin E syndrome (HIES) is a rare primary immunodeficiency disease characterized by recurrent infections and elevated levels of serum immunoglobulin E, usually over 2000 IU/mL. Recurrent and chronic infection of the epidermis and squamous epithelium may also be a cause of squamous cell carcinoma (SCC). SCC is rare with HIES. CASE REPORT: A 17-year-old male patient who was diagnosed as HIES was admitted with purulent right ear discharge. The patient had a history of eczema starting from the age of 7 months and a history of recurrent middle ear infection starting from the age of 5. Biopsy specimens were taken from the lesion in the external auditory canal, and the lesion was reported as SCC. CONSLUSION: Patients with autosomal recessive HIES are at an increased risk for infections and malignancies. SCC should be considered in the differential diagnosis of the patients presenting with recurrent middle ear infections and immunodeficiency.

Effects of Selective Seratonine Re-Uptake Inhibitors on Meniere's Disease.

OBJECTIVE: To evaluate the effects of selective serotonin re-uptake inhibitors (SSRIs) on Meniere's disease (MD) on patients who have both MD and generalized anxiety disorder. MATERIALS AND METHODS: All patients were evaluated with neurotologic examination, videonystagmography, audiological tests, and inner ear magnetic resonance imaging. Characteristic history and the evaluation of the patients' vertigo attacks during the attacks were the primary criteria for the diagnosis of MD. According to these parameters, 12 patients were diagnosed with definite MD and also symptoms of generalized anxiety disorder. Escitalopram 10 mg was prescribed to the patients. The clinical records of these patients were reviewed. RESULTS: Eight female and 4 male patients with MD and generalized anxiety disorder were included. The average age was found to be 46.25 years (34-63 years). Magnetic resonance imaging of patients was reported as normal. All patients had unilateral MD. The patients were diagnosed with MD for 2-12 years (mean: 5 years). All patients used betahistine and diuretics before escitalopram. Intratympanic gentamicin was also applied to one patient. After escitalopram medication, no vertigo attack was observed in any of the patients. CONCLUSION: SSRIs may have a central balancing effect on vertigo attacks of MD. Escitalopram can control vertigo attacks in MD. Further studies are needed to support this effect.

Cochlear Implantation in Patient with Cochlear Nerve Deficiency: A Case Report.

Diagnostic imaging methods are very important for patients with bilateral sensourinoural hearing loss. Magnetic resonance imaging (MRI) is able to demonstrate the vestibulocochlear nerve and facial nerve in the internal acoustic canal. Also computed tomography can be helpful to determination of the deficiency of the cochlear nerve. Cochlear nerve anomalies are classified into three group according to the magnetic resonance imagings. Patients who have cochlear nerve deficiency may not hear with cochlear amplifications. Auditory brain stem implant (ABI) is most suitable for these cases. In this case report, we presented a 3 years old girls with bilateral totally hearing loss who performed cochlear implantation despite of cochlear nerve deficiency on magnetic resonance imaging (MRI) and computed tomography (CT).

Alternative Techniques in Cochlear Implantation.

OBJECTIVE: To review the alternative techniques in cochlear implantation and to compare the complications with different techniques. MATERIALS AND METHODS: Patients who had undergone cochlear implantation were reviewed. Those patients who were operated using alternative techniques were selected and evaluated for the cause of their hearing loss and for the type of alternative technique that was utilized. Complication types and rates in these patients were evaluated. RESULTS: In total, 38 patients were operated using alternative techniques following preoperative or intraoperative findings. The mean age of the patients was 8.3 (1-51) years. There were 20 male and 18 female patients. Thirteen patients were operated with a suprameatal approach and 18 with a transcanal approach. Resection of the bony part of the external ear canal and reconstruction (canal wall down technique) was performed in seven patients. Postoperative complications included wound infection, hematoma, chorda tympani injury, and tympanic membrane perforation. CONCLUSION: Cochlear implantation is an effective method in the rehabilitation of sensorineural hearing loss. Complications are rare but can sometimes cause hematoma, taste impairment, tympanic membrane perforation, or wound infections. The standard procedure is not always suitable for patients with temporal bone abnormalities. Surgeons performing cochlear implantation should be aware of these variations and should be able to perform alternative implant techniques in these cases.

Quality of Life in Pediatric Cochlear Implantations.

OBJECTIVE: To evaluate the satisfaction of patients with a cochlear implant using a Parents' Perspective Questionnaire and analyze the significant parameters. MATERIALS AND METHODS: Patients who received a cochlear implant in Çukurova University between March 2002 and November 2012 were included in the study. Parents were asked to answer the Parents' Perspective Questionnaire. RESULTS: The age ranges of 62 patients were 2-5 years and of 99 patients were 6-11 years and over. In total, 144 parents were satisfied with the cochlear implant. Patients who attended school had more self-confidence, and users of an implant aged over 18 months had better social relations and self-confidence. CONCLUSION: Cochlear implants' positive effect on the quality of life is a fact, but parents have concerns in the preoperative and postoperative periods. Patients and parents should be informed carefully about cochlear implants. Also, patients' satisfaction is correlated with increasing duration of the implant and age.

Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations.

OBJECTIVE: The purpose of this study is to assess complications occurring after cochlear implantation (CI) in children and to discuss revision surgeries and medical interventions occurring during follow-up. STUDY DESIGN: Retrospective study of 475 consecutive pediatric cochlear implantations at a tertiary referral center. METHODS: The patients (n = 475) who received cochlear implants in our institution between March 2000 and March 2012 were followed up (range, 5 months-12 years). All complications were systematically reviewed, and their causes were analyzed for prevention and therapy. RESULTS: All children received unilateral CI. Mean age at implantation was 3 years 7 months (ranged from 10 months to 18 years). Forty-three patients (9%) experienced complications. Twenty-one patients (4.4%) had major complications, consisting of device failure (10 patients), flap necrosis (4 patients), meningitis (2 patients), electrode shifting (2 patients), hematoma (2 patients) and magnet migration (1 patient). Twenty-two (4.6%) had minor complications, consisting of acute otitis media (5 patients), skin lesion due to pressure reaction in contralateral ear during surgery (4 patients), flap swelling (3 patients), minor wound infection (3 patients), transient facial paralysis (2 patients), transient vertigo (2 patients), hematoma (1 patient), facial stimulation (1 patient), subcutaneous emphysema (1 patient). Complications led to reimplantation in 13 (30.2%) and other revision surgery in 7 (16.2%) of the 43 patients. One patient with meningitis cured with medical treatment and 22 patients with minor complications cured with either medical treatment or spontaneously. CONCLUSIONS: Cochlear implantation is a safe technique in experienced hands with a relatively low complication rate. Long term follow up is mandatory to minimize and control surgical complication.

Factors contributing to limited or non-use in the cochlear implant systems in children: 11 years experience.

OBJECTIVES: The aim of this study was to analyze the incidence and etiologic factors of non-use and limited use of cochlear implants. The patients' age, gender, duration of implantation and additional disabilities were investigated. PATIENTS AND METHODS: Of the 413 (200 males, 213 females) pediatric patients (age under 16) implanted in our clinic between January 2000 and December 2011, 12 limited user/non-user cochlear implanted patients were selected who had a follow-up of at least 24 months. Preoperative and postoperative listening progress profile (LiP) and meaningful auditory integration scale (MAIS) tests were performed to analyze the auditory performances of the patients. RESULTS: In total of 12 recipients (2.90%) (7 male and 5 female patients; age range, 5-13 years), 4 (0.96%) patients were non-users and 8 (1.93%) patients were limited users. The patients had some additional disabilities as autism, cerebral palsy, moderate mental retardation, attention deficit/hyperactivity disorder, ossified cochlea due to meningitis and learning disability-lack of family interest. None had experienced device failure. In the postoperative 24th month, listening progress profile and meaningful auditory integration scale test scores were better in the limited users as expected. CONCLUSIONS: It should always be considered in patients with additional factors like autism, mental-motor retardation, learning disabilities that they will show limited development from cochlear implantation. These patients are potential limited/non-users. These patients require unique rehabilitation and provide high family and educational interest.

[Auditory performance analyses of cochlear implanted patients]. / Koklear implant uygulanan hastalarin isitsel performans analizleri.

OBJECTIVES: The aim of this study was to analyze the auditory performance development of cochlear implanted patients. The effects of age at implantation, gender, implanted ear and model of the cochlear implant on the patients' auditory performance were investigated. PATIENTS AND METHODS: Twenty-eight patients (12 boys, 16 girls) with congenital prelingual hearing loss who underwent cochlear implant surgery at our clinic and a follow-up of at least 18 months were selected for the study. Listening Progress Profile (LiP), Monosyllable-Trochee-Polysyllable (MTP) and Meaningful Auditory Integration Scale (MAIS) tests were performed to analyze the auditory performances of the patients. To determine the effect of the age at implantation on the auditory performance, patients were assigned into two groups: group 1 (implantation age = or <60 months, mean 44.8 months) and group 2 (implantation age = or <60 months, mean 100.6 months). RESULTS: Group 2 had higher preoperative test scores than group 1 but after cochlear implant use, the auditory performance levels of the patients in group 1 improved faster and equalized to those of the patients in group 2 after 12-18 months. Our data showed that variables such as sex, implanted ear or model of the cochlear implant did not have any statistically significant effect on the auditory performance of the patients after cochlear implantation. CONCLUSION: We found a negative correlation between the implantation age and the auditory performance improvement in our study. We observed that children implanted at young age had a quicker language development and have had more success in reading, writing and other educational skills in the future.

Castleman-like reaction due to toxic substance ingestion.

Castleman disease (CD) is an uncommon lymphoproliferative disorder with a unique histopathology. Generally diagnosis is not difficult for an experienced pathologist. However, not usually, some histopathological entities or tissue reactions may mimic CD. Here CD-like reaction due to toxic substance ingestion has been presented.

Rigid bronchoscopy for the suspicion of foreign body in the airway.

OBJECTIVE: Airway foreign bodies present a diagnostic dilemma and has been recognized for many years. Since aspiration of foreign bodies can be a serious and sometimes fatal problem, early intervention and proper management is vital. METHOD: In this retrospective study, the results of 1887 bronchoscopies, which were performed between the years 1973 and 2004 for the suspicion of foreign body aspiration in children, were presented. Various instruments and techniques were used over 31-year period and rigid bronchoscopy was the preferred method of foreign body extraction. RESULTS: There were 1106 boys and 781 girls with the median age of 2.3 years. Seventy-four percent of patients were less than 3 years old. The most common type of foreign body (89.9%) was organic; watermelon seeds (39.7%) were the most frequent organic foreign bodies. Eight hundred and twenty-three patients (43.6%) were referred to our clinic within the first 24h of the event while 4.5% of the patients were admitted to the hospital with the suspicion of foreign body in the airway later than one month. At bronchoscopy, a foreign body was identified in 79.1% of patients and no foreign body was seen in 20.9% of patients. Foreign bodies were encountered in 96.3% of the patients with positive history whereas 28.1% of the patients with negative history had foreign body. Of the patients with foreign bodies, 93.2% had positive history. Overall, the positive history was obtained from 85.2% of patients. The incidence of postbronchoscopic tracheotomy, thoracotomy, and overall mortality rate were 0.47, 0.15, and 0.21%, respectively. CONCLUSION: Otolaryngologists should consider foreign body aspiration in the airway in the differential diagnosis of any patient with the complaints of stridor, dyspnea, sudden onset of cough and intractable and recurrent lower respiratory tract infections. A careful history and physical examination were strong indicators of the diagnosis and raised the index of suspicion of an aspirated foreign body. Timely intervention with the experienced surgical team would decrease the complication rate and mortality rate. However, prevention of aspiration with the education of parents and caregivers is very important.

The antibiotic prescribing behaviourof physicians for acute tonsillopharyngitis in primary care.

OBJECTIVES: Acute tonsillopharyngitis is one of the most common reasons for antibiotic use although it is mostly viral. There seems to be a large variation between physicians in prescribing antibiotics. The aim of this study was to explore the antibiotic prescribing behaviour of physicians while treating cases with acute tonsillopharyngitis. PATIENTS AND METHODS: Data were collected using a questionnaire designed to investigate the effect of the antibiotics actively promoted by pharmaceutical companies, the sociodemographic details of primary care physicians, the geographic location (urban-rural) of the primary care organizations, and the effect of laboratory investigations on provider antibiotic prescribing behaviour in the treatment of acute tonsillopharyngitis. Sixty six primary care organisations (PCOs) and 316 primary care physicians working in the 66 PCOs in Adana in 2001 were involved in the study. RESULTS: Out of 66 PCOs, 55 (83%) were urban and 11 (16%) were rural. The response rate was 79%. There was significant association between antibiotic prescription for acute tonsillopharyngitis and geographic location, antibiotic promotion by pharmaceutical companies and postgraduate training for physicians (p = 0.001, p = 0.0001, p = 0.0001, respectively). There was also significant association between laboratory investigation and geographic location, postgraduate training for physicians, and period since graduation (p = 0.0001, p = 0.0001, p = 0.003, respectively). CONCLUSIONS: Antibiotics in cases with acute tonsillopharygitis are more frequently prescribed in rural areas and in PCOs where the visits and motivation from pharmaceutical companies are intensive. Physicians without postgraduate vocational training prescribe more antibiotics for cases with acute tonsillopharyngitis.

The role of food allergy in otitis media with effusion.

OBJECTIVE: To detect the relationship between food allergy and otitis media with effusion (OME). MATERIALS AND METHODS: This study was performed on three different groups. The patient group was made up of 56 patients with OME (group I). There were 28 patients with food allergy in group II and these patients were investigated for OME. The control group consisted of 28 patients without any complaints concerning food allergy or OME (group III). RESULTS: Food allergy was detected in 25 patients with OME (44.6%) (group I). In patients with food allergy (group II), OME was detected in 7 patients (25%). In the control group (group III) food allergy was diagnosed in 5 patients (18%) and OME in 1 patient (3%). The incidence of food allergy in OME group was statistically significant when compared to the normal group (P > 0.05). CONCLUSIONS: This study demonstrates that food allergy may play a role in the etiopathogenesis of OME.