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Background and Objectives:Mast cells are localized in the midle ear and Eustachian tube. They play a prominent role in the inflamatory and allergic conditions. The purpose of this study is to investigate if different inflamatory reactions depend on whether patients are allergic or not by measuring concentration of the mast cell tryptase that reflects the mast cell activity. :Twenty-five patients with chronic otitis media with efusion (COME) were studied. Thirteen patients were confirmed allergy positive by multiallergosorbent test. Mast cell tryptase in the middle ear efusions was measured using western blotting. Results:Mast cell tryptase was more strongly expressed in the efusions with allergy positive than in the allergy negative (p<0.01). Conclusion:There was a correlation between mast cell tryptase from ME and allergy, so we conclude that allergy plays a role in the pathogenesis of COME. (Korean J Otolaryngol 2002;45:111-3)