Do Nasal Allergies Cause Ear Infections?

Ear Infections and Allergic Rhinitis

Nasal allergies can predispose children to ear infections.

Do Nasal Allergies Cause Ear Infections?

Middle ear infections (otitis media) are one of the most common reason why kids see a doctor. I remember having ear infections as a child – the deep ache, with pain so severe that I couldn’t really do anything other than just lie in bed. Most middle ear infections are due to viral and bacterial infections, but do allergies play a role in causing chronic or recurrent ear infections?

There are many factors involved in ear infections. These include the age and genetic background of the person, shape of the middle ear structures, as well as exposure to infections, allergens and irritants (such as tobacco smoke). Many studies have shown that children with allergic rhinitis are at increased risk for developing chronic ear infections. The reasons why allergy causes middle ear infections aren’t completely clear; it appears that the middle ear acts similar to the nose when exposed to allergens and is also affected by the swelling within the nasal passages (causing eustachian tube dysfunction) that occur with allergies.

People with chronic ear infections associated with allergies have been treated in a variety of ways, including oral antihistamines with and without decongestants, prescription nasal sprays (nasal steroids and nasal antihistamines), as well as allergy shots. An analysis of several studies in 2006 found no benefit for oral antihistamines with or without decongestant for the treatment of children with chronic ear infections.

Studies have not shown a consistent benefit of nasal steroids for treatment of chronic ear infections; it is not known if allergy shots would be beneficial, although it makes sense that these would help for people whose ear infections are related to allergy.


Skoner DP, Casselbrant ML. Otitis media.

In: Middleton EJR, Reed CHE, Ellis EF, Franklin Adkinson NJR, Yunginger JW, Busse WW, eds. Allergy: Principles & Practice. 6th ed. St Louis, MO: Mosby-Year Book Inc; 2003:1437-1454.

Griffin GH, Flynn C, Bailey RE, Schultz JK. Antihistamines and/or Decongestants for Otitis Media with Effusion (OME) in Children. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD003423.

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