The Inner Ear in Patients with Nasal Allergy

Abstract

The endolymphatic sac has been proposed as a target organ responsible for inner-ear symptom in allergic subjects. This is a report of inner-ear symptoms in patients with nasal allergy. Retrospective review of record charts of patients with known nasal allergy presenting to the otorhinolaryngology out-patient department of the University College Hospital, Ibadan in 5 years. Ear symptoms were found in 95/144 (66%) subjects with nasal allergy. This comprises of 41 males and 44 females (M: F = 1:1). Of these, itching of the external ear canal, hearing loss and tinnitus accounted for 63 (66%), 55 (58%) and 39 (41%), respectively, while vertigo was found in 12 (13%). Peripheral vestibular signs of imbalance were seen in 11/95. The audiological assessment of 73 subjects revealed normal pure-tone average in 43 (59%), and sensorineural hearing loss (SHL) in 17 (23.3%). The severity of SHL was mild in 6/17, moderate in 7 and moderate-to-severe in 4. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated in 10/15 (67%) and 6/15 (40%), while the skin sensitivity test showed reactions to dust in 32, cold in 25, cockroach in 7, perfume in 11, vegetable oil in 1 and insecticide in 2. The clinical diagnoses were idiopathic tinnitus in 25 (26.3%), Idiopathic SHL in 17 (18%), cochlear hydrop in 6 (6%) and autoimmune inner-ear disease in 6 (6%). This report suggests some peculiar predisposition to inner-ear pathology in patients with nasal allergy. However a longitudinal assessment of cochleovestibular features of nasal allergy subjects will help in its validation.