Fatores de risco para otite média secretora
Risk factors for otitis media with effusion
Mario Sánchez-Borges; Nelson Rosário Filho
Resumo
A patogênese da otite média secretora é multifatorial e envolve a resposta imunológica, fatores genéticos e anatômicos. Muitos dos fatores relacionados à otite média aguda também têm sido pos‑ tulados como relevantes para a otite média crônica e recorrente. Evidências indicam que não há diferenças na função da tuba au‑ ditiva entre orelhas que desenvolvem otite médica crônica (OMC) recorrente e as que não têm OMC. A mucosa da orelha média reage igualmente à inflamação alérgica respiratória. Atopia pode promover disfunção tubária ou reação direta no epitélio da tuba auditiva. Obstrução da tuba auditiva não é o mecanismo principal de OMC, mas a inflamação alérgica do epitélio respiratório da orelha média. Alergia ao leite de vaca é rara em crianças com otite média secretora, no entanto sensibilização a alérgenos inaláveis deve ser investigada, e em casos selecionados, imunoterapia especÃfica pode ser empregada.
Palavras-chave
Abstract
The pathogenesis of otitis media with effusion (OME) is multifactorial and involves immune response, genetic and anatomical factors. Many of the factors related to acute otitis media have also been postulated as relevant for chronic and recurrent otitis media. There is evidence suggesting that there are no differences in Eustachian tube function between ears with recurrent chronic otitis media and those without the condition; the middle ear mucosa has a similar reaction to allergic airway inflammation. Atopy may promote tube dysfunction or a direct reaction in tube epithelium. Eustachian tube obstruction is not the main mechanism of chronic otitis media; rather, allergic inflammation of the middle ear epithelium is. Cow’s milk allergy is rare in children with OME, but sensitivity to inhalant allergens should be investigated, and selected cases treated with immunotherapy.
Keywords
Referências
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Submetido em:
10/01/2017
Aceito em:
15/02/2017
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