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Hurst DS, Denne CM. The Relation of Allergy to Eustachian Tube Dysfunction and the Subsequent Need for Insertion of Pressure Equalization Tubes. EAR, NOSE & THROAT JOURNAL 2020; 99:39S-47S. [PMID: 32320297 DOI: 10.1177/0145561320918805] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION The most basic question to be answered in each case in which the choice of using a pressure equalization tube (PET) is being considered is: "what is the underlying pathophysiology of the middle ear disease being addressed?" METHODS We will evaluate the hypothesis that the Eustachian Tube (ET) may become "dysfunctional" due to allergic mucosal edema and obstruction. We review the literature that evaluates the role of ET, the proposed affect that allergy may contribute to ET dysfunction (ETD), and the relation of allergic rhinitis to otitis. RESULTS Proof that allergy affects the middle ear was supported by (1) over a dozen investigators using objective immunotherapy demonstrating over the past 70 years that 72% to 100% of the children with otitis media with effusion (OME) are atopic, (2) an association of allergic Th2 immune-mediated histochemical reactivity within the target organ itself, (3) establishment that inflammation within the middle ear is truly allergic in nature, and (4) direct evidence of a dose-response curve and consistency of results, which confirm that OME resolves on allergy immunotherapy. CONCLUSION Current medical evidence should heighten the awareness of physicians of the physiology that underlies ETD. The evidence supports the link between allergy and OME. The middle ear behaves like the rest of the respiratory tract, and what has been learned about the atopic response in the sinuses and lungs may be applied to the study of the immunologic mechanisms within the middle ear that lead to ETD requiring the use of PET.
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Affiliation(s)
- David S Hurst
- Otolaryngology, 1867Tufts University, Boston, MA, USA
| | - Carter M Denne
- 6595University of Pittsburg Medical Center, Erie, PA, USA
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Analysis of factors associated with multiple ventilation tube insertions in children with otitis media with effusion. The Journal of Laryngology & Otology 2019; 133:281-284. [DOI: 10.1017/s0022215119000495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo determine the factors related to multiple ventilation tube insertions in children with otitis media with effusion.MethodsA retrospective review was performed of 126 ears of 81 children aged less than 12 years who had undergone insertion of a Paparella type 1 ventilation tube for the first time between August 2012 and March 2018.ResultsMean age at the first operation was 4.0 ± 2.2 years, and the mean duration of otitis media with effusion before the first ventilation tube insertion was 5.4 ± 4.5 months. Among 126 ears, 80 (63.5 per cent) had a single ventilation tube insertion and 46 (36.5 per cent) had multiple insertions. On multivariate logistic regression, tympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion were independent predictive factors of multiple ventilation tube insertions.ConclusionTympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion after the first tube extrusion are associated with multiple ventilation tube insertions.
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Zernotti ME, Pawankar R, Ansotegui I, Badellino H, Croce JS, Hossny E, Ebisawa M, Rosario N, Sanchez Borges M, Zhang Y, Zhang L. Otitis media with effusion and atopy: is there a causal relationship? World Allergy Organ J 2017; 10:37. [PMID: 29158869 PMCID: PMC5684754 DOI: 10.1186/s40413-017-0168-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 09/13/2017] [Indexed: 12/14/2022] Open
Abstract
Otitis Media with Effusion (OME) is an inflammatory condition of the middle ear cleft, acute or chronic, with collection of fluid in the middle ear with an intact tympanic membrane. It is a very common disease in childhood, the most frequent cause of hearing loss in childhood and often requiring surgery. OME is called chronic when the fluid in the middle ear persists for more than three months or when the episodes recur six or more times in one year. The current article covers various aspects of OME including definition, epidemiology. Pathomechanisms, risk factors, role of allergy in OME, impact of upper airway disease on OME, eosinophilic otitis media and management of OME.
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Affiliation(s)
- Mario E. Zernotti
- Department of Otolaryngology, Catholic University of Córdoba, Córdoba, Argentina
| | - Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Ignacio Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - Hector Badellino
- Department of Pediatric Respiratory Medicine, Regional Eastern Clinic, San Francisco, Córdoba, Argentina
| | | | - Elham Hossny
- Pediatric Allergy Unit, Children’s Hospital, Ain Shams University, Cairo, Egypt
| | - Motohiro Ebisawa
- Department of Pediatrics, National Sagamihara Hospital, Sagamihara-shi, Kanagawa Japan
| | | | - Mario Sanchez Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Yuan Zhang
- Department of Otolaryngology – Head and Neck Surgery, Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology – Head and Neck Surgery, Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
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Barenkamp SJ, Ogra PL, Bakaletz LO, Chonmaitree T, Heikkinen T, Hurst DS, Kawauchi H, Kurono Y, Leiberman A, Murphy TF, Patel JA, Sih TM, St Geme JW, Stenfors LE. 5. Microbiology and Immunology. Ann Otol Rhinol Laryngol 2016. [DOI: 10.1177/00034894051140s109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sinonasal symptoms in adults with ear disease. The Journal of Laryngology & Otology 2014; 128:438-41. [DOI: 10.1017/s002221511400084x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:The association between eustachian tube dysfunction and middle-ear effusion is well established. Studies have also demonstrated pathological changes affecting the middle-ear mucosa associated with chronic sinonasal inflammation. No previous studies have evaluated symptoms related to sinonasal inflammatory disease in different ear diseases.Objective:To assess the presence of sinonasal symptoms in ear diseases using the Dundee Rhinogram.Methods:Data were collected prospectively in the period February–October 2011. Sinonasal symptoms were graded using the Dundee Rhinogram. Student'st-test analyses were performed to identify any statistically significant associations.Results:In total, 164 patients were assessed. There was a statistically significant association between sinonasal symptoms and mucosal middle-ear diseases (p < 0.005). The mean sinonasal symptoms score for mucosal middle-ear disease patients was 5.94 (range, 0–32).Conclusion:Assessment of sinonasal symptoms is paramount in patients presenting with an ear symptom; inflammatory sinonasal disease treatment may become necessary in the management of middle-ear mucosal disease for better patient outcome.
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Chantzi FM, Bairamis T, Papadopoulos NG, Kafetzis DA. Otitis media with effusion: an effort to understand and clarify the uncertainties. Expert Rev Anti Infect Ther 2014; 3:117-29. [PMID: 15757462 DOI: 10.1586/14787210.3.1.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Otitis media with effusion--defined as the accumulation of middle-ear effusion behind an intact tympanic membrane without signs or symptoms of acute infection--is one of the most common causes of hearing loss in children in developed countries, potentially leading to language deficits. Although treatment of chronic or relapsing otitis media with effusion is considered imperative, none of the preventative or nonsurgical management measures currently available have proven effective. Tympanostomy tube placement remains the recommended treatment option for high-risk children or for cases of unresponsive otitis media with effusion. This can be attributed to the uncertainties surrounding its pathogenesis. Multiple factors and several possible pathogenetic models have been proposed to explain the production and persistence of middle-ear effusion; only a few of them are supported by sufficient evidence. In this review, the authors will present current knowledge on the pathogenesis, consequences, diagnosis and management of otitis media with effusion. An effort will be made to clarify those aspects sufficiently supported by evidence-based studies, and to underline those that remain unfounded.
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Affiliation(s)
- Fotini-Maria Chantzi
- University of Athens, Second Department of Pediatrics, and the ENT department, P and A Kyriakou Children's Hospital, Athens 115 27, Greece
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Prevalence of preventable ear disorders in over 15,000 schoolchildren in northern India. The Journal of Laryngology & Otology 2012; 127:28-32. [PMID: 23218257 DOI: 10.1017/s0022215112002691] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is a considerable scarcity of reliable population-based data on the prevalence of preventable ear disorders in developing countries. This study was conducted to determine the prevalence of preventable ear disorders in primary school children (aged 5 to 12 years) in northern India. METHOD A pro forma questionnaire was used to screen 15 718 primary school children in New Delhi for ear disorders. Ear examinations were conducted using otoscopy and impedance audiometry. RESULTS Impacted cerumen was prevalent in 7.93 per cent of schoolchildren, 4.79 per cent suffered from chronic otitis media and 3.06 per cent suffered from otitis media with effusion. Acute otitis media was detected in 0.65 per cent and foreign bodies were found in 0.34 per cent of the children. CONCLUSION Preventable ear diseases posed a significant health problem among children at primary school level. Regular screening of children during this stage would ensure that their school lives were not affected by hearing impairments or preventable ear disorders. Information gathered in this study will help in effective treatment prioritisation of ear disorders, planning and resource allocation.
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Abstract
The role of allergy in chronic otitis media with effusion (OME) is controversial. New evidence from cellular biology and immunology explain the basics of allergic reactions and allow more accurate diagnosis of allergies and inflammatory disease throughout the unified airway. This article examines the epidemiologic, methodological, and immunologic studies of allergic causes of OME, including (1) evidence for and against OME as an allergic disease, (2) allergy as a cause for eustachian tube obstruction, (3) examination of the most sensitive diagnostic tests for allergy, and (4) the effect of treatment of underlying allergies in improving and resolving middle ear disease.
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Immune modulatory oligonucleotides in the prevention and treatment of allergen-induced eustachian tube dysfunction in the animal model. Curr Allergy Asthma Rep 2008; 8:508-12. [PMID: 18940142 DOI: 10.1007/s11882-008-0093-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This article reviews the current literature investigating the applications and success of immune modulatory oligonucleotides as immunotherapy to treat and prevent allergen-induced eustachian tube dysfunction in animal models. Synthetic DNA-based immunotherapy agents composed of unmethylated cytosine-guanine dinucleotides (CpG ODNs) that bind to Toll-like receptors have been found to have tremendous potential as therapeutic agents and adjuvants. CpG ODNs can induce a shift in the cytokine profile and immune response that favors the T-helper type 1 pathway and suppresses the T-helper type 2 pathway. This makes CpG ODNs promising candidates for treating allergic diseases. Current CpG ODN studies have demonstrated prevention and treatment of acute allergen inflammation of the eustachian tube in an animal model of otitis media. Immune modulatory oligonucleotides in immunotherapy, administered systemically or topically, have been shown to be safe and effective in the animal model.
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Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3052] [Impact Index Per Article: 190.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
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Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
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Patel JA, Nair S, Revai K, Grady J, Saeed K, Matalon R, Block S, Chonmaitree T. Association of proinflammatory cytokine gene polymorphisms with susceptibility to otitis media. Pediatrics 2006; 118:2273-9. [PMID: 17142509 DOI: 10.1542/peds.2006-0764] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Susceptibility to otitis media results from complex interactions among genetic factors of the host, exposure to pathogens, and environmental influences. The objective of this study was to study the role of single-nucleotide polymorphisms of regulatory elements of proinflammatory cytokine genes tumor necrosis factor-alpha(-308), interleukin-1beta(+3953), and interleukin-6(-174), in susceptibility to recurrent otitis media in childhood. METHODS A total of 505 children (296 otitis media susceptible, 209 nonsusceptible as control) were enrolled at 2 sites (Texas and Kentucky). DNA of the children was studied for specific single-nucleotide polymorphisms by restriction fragment length polymorphism assay and confirmed by gene sequencing. RESULTS In the overall study group, tumor necrosis factor-alpha(-308) and interleukin-6(-174) heterozygous or homozygous polymorphisms (high cytokine-producing genotypes) were significantly associated with otitis media susceptibility. The same association was found in a match-paired subgroup of 384 subjects. In the overall study group, there was a significant step-wise increase in otitis media susceptibility with increasing number of concomitant polymorphic genotypes. Simultaneous combination of tumor necrosis factor-alpha(-308) and interleukin-6(-174) polymorphisms further increased the risk for otitis media susceptibility. These 2 polymorphic genotypes also were associated with the increased risk for tympanostomy tube placement. Children who had tumor necrosis factor-alpha(-308) polymorphism and were breastfed for <1 month or exposed to cigarette smoke were more likely to be otitis media susceptible. CONCLUSIONS Our data suggest that tumor necrosis factor-alpha(-308) and interleukin-6(-174) polymorphisms are associated with increased risk for otitis media susceptibility and placement of tympanostomy tubes. Environmental factors such as breastfeeding may modify the risk for otitis media susceptibility in polymorphic individuals.
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Affiliation(s)
- Janak A Patel
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX 77555-0371, USA
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Ebert CS, Rose AS, Patel MR, Hardy SM, Kandimalla ER, Agrawal S, Prazma J, Pillsbury HC. The role of immunomodulatory oligonucleotides in prevention of OVA-induced Eustachian tube dysfunction. Int J Pediatr Otorhinolaryngol 2006; 70:2019-26. [PMID: 16939693 DOI: 10.1016/j.ijporl.2006.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2006] [Accepted: 07/14/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the potential role of immunomodulatory oligonucleotides (IMO) in the prevention of OVA-induced Eustachian tube dysfunction (ETD) in a rat model. METHODS Brown-Norway rats were sensitized to ovalbumin (OVA) and randomized to receive pre-treatment with IMO or phosphate buffered saline (PBS). After systemic sensitization, subjects received a transtympanic OVA challenge followed by evaluation of the Eustachian tube's dynamic function. RESULTS Pre-treatment of OVA sensitized animals with IMO normalized passive opening and closing Eustachian tube pressures, improved active clearance of negative pressure in the middle ear, and resulted in reduced mean mucociliary transit times compared to untreated OVA-sensitized animals (P<0.001). CONCLUSION These data demonstrate that pre-treatment with IMO prevent OVA-induced ETD in the rat. IMO treatment in the future may offer considerable promise in the management of OME in children.
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Affiliation(s)
- Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, CB# 7070, G0412 Neurosciences Hospital, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7070, United States.
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Chantzi FM, Kafetzis DA, Bairamis T, Avramidou C, Paleologou N, Grimani I, Apostolopoulos N, Papadopoulos NG. IgE sensitization, respiratory allergy symptoms, and heritability independently increase the risk of otitis media with effusion. Allergy 2006; 61:332-6. [PMID: 16436142 DOI: 10.1111/j.1398-9995.2006.00971.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Epidemiological evidence examining the role of atopy and/or allergy in the pathogenesis of otitis media with effusion (OME) is inconclusive. The aim of this study was to assess any increased risk for OME attributable to allergy-related factors, in a well-characterized population using a case-control design and multivariate analysis. SUBJECTS AND METHODS Eighty-eight 1-7-year-old children with OME, diagnosed by clinical and tympanometric evaluation and 80 matched controls were enrolled. A standardized questionnaire was completed, in order to assess factors related to OME and allergy-related symptoms and diagnoses using strict clinical definitions. Specific IgE was measured by skin-prick tests and/or CAP-FEIA. RESULTS The patient and control groups were well matched. Factors conferring increased risk for OME in the univariate analysis included IgE sensitization, dyspnea, wheezing, asthma, paroxysmal sneezing, rhinitis, eczema, 'any allergic disease,' family history of otitis media, and family history of allergy. After multivariate analysis IgE sensitization, wheezing, nasal obstruction, family history of otitis, and child-care attendance remained as independent risk factors for development of OME. CONCLUSION IgE sensitization and respiratory allergy symptoms are independent risk factors for the development of OME, suggesting that both immunological and mechanical pathways may contribute to the development of the disease. Otitis heritability provides additional risk, as well as frequent exposure to viral upper respiratory tract infections in children attending daycare. Treatment and/or prevention of OME using anti-allergic medications should be further examined.
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Affiliation(s)
- F M Chantzi
- Department of Allergy, 2nd Pediatric Clinic, P. & A. Kyriakou Children's Hospital, Athens, Greece
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Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001; 108:S147-334. [PMID: 11707753 DOI: 10.1067/mai.2001.118891] [Citation(s) in RCA: 2094] [Impact Index Per Article: 91.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- J Bousquet
- Department of Allergy and Respiratory Diseases, University Hospital and INSERM, Montpellier, France
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Bennett KE, Haggard MP. Accumulation of factors influencing children's middle ear disease: risk factor modelling on a large population cohort. J Epidemiol Community Health 1998; 52:786-93. [PMID: 10396519 PMCID: PMC1756656 DOI: 10.1136/jech.52.12.786] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STUDY OBJECTIVES Data were analysed from a large national birth cohort to examine cumulative and interactive prediction from various risk factors for childhood middle ear disease, and to resolve conflicting evidence arising from small and incompletely controlled studies. The large sample size permitted appropriate covariate adjustment to give generality, and permit demographic breakdown of the risk factors. SETTING A large multi-purpose longitudinal birth cohort study of all births in the UK in one week in 1970, with multiple questionnaire sweeps. PARTICIPANTS Over 13,000 children were entered into the original cohort. Data on over 12,000 children were available at the five year follow up. MAIN OUTCOME MEASURES For children at 5 years, parent reported data were available on health and social factors including data on two markers for middle ear disease: the occurrence of purulent (nonwax) ear discharge and suspected or confirmed hearing difficulty. MAIN RESULTS In those children who had ever had reported hearing difficulty (suspected or confirmed), after control for socioeconomic status, three of the classic factors (male sex, mother's smoking habits since birth, and attending day care) were significantly more frequent. In those who had ever had ear discharge reported, only mother's smoking habit since birth was significantly more frequent. However, it showed an orderly dose response relation. In addition, a derived general child health score was found to be significantly associated with both the middle ear disease markers. Control for this variable in the analysis of those having reported hearing difficulty reduced the effect size of mother's smoking habit, but it remained statistically significant. For reported ear discharge, even after control for the general health score and social index, mother's smoking habits and day care attendance were both significant predictors. Mother's (but not father's) smoking habits and day care attendance were found to be significant risk factors for middle ear disease. Breast feeding effects were weak and did not generally survive statistical control. CONCLUSIONS A child having all three risk factors (attends day care, a mother who smokes, and male sex) is 3.4 times more likely to have problems with hearing than a child who has none, based on cumulative risk. Further studies should focus on preventative risk modification and well specified intervention.
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Affiliation(s)
- K E Bennett
- MRC Institute of Hearing Research, Nottingham
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Apostolopoulos K, Xenelis J, Tzagaroulakis A, Kandiloros D, Yiotakis J, Papafragou K. The point prevalence of otitis media with effusion among school children in Greece. Int J Pediatr Otorhinolaryngol 1998; 44:207-14. [PMID: 9780065 DOI: 10.1016/s0165-5876(98)00002-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Tympanometry, pneumatic otoscopy and acoustic reflex tests performed on 5121 school children aged 6-12 years old, during late spring and early autumn of 1996. Demographic, social, medical and birth related data were collected for each child separately. The study was undertaken in order to evaluate the prevalence of otitis media with effusion in a sample of the general population in Greece and to investigate the correlations with possible risk factors. A total of 6.5% had unilateral or bilateral type B or C2 tympanogramms, and negative reflex suggestive of otitis media with effusion. The finding indicates a rather low prevalence of otitis media with effusion in school children in Greece compared with other countries. This study, also has shown that there was a statistical significant relationship between secretory otitis media (SOM) and, age, sex, mother's education, parental smoking, breast-feeding, allergy and previous otitis media. No correlation was found in relation to the climate of residence, premature birth, number of siblings, mother's gestational age, birth skull circumference, birth body weight and length.
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Affiliation(s)
- K Apostolopoulos
- Ear Nose and Throat Department, Faculty of Medicine, University of Athens, Hippokration Hospital of Athens, Greece
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Maurer D, Stingl G, Röcken M, Merk HF, Rappersberger K, Bialasiewicz AA, Müller U, Leonhardt L, Schwanitz HJ, John SM, Gieler U, Baur X, Bischoff SC, Heppt W, Wahn U. Klinik. ALLERGOLOGIE 1998. [DOI: 10.1007/978-3-662-05660-8_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Stenström C, Ingvarsson L. Otitis-prone children and controls: a study of possible predisposing factors. 2. Physical findings, frequency of illness, allergy, day care and parental smoking. Acta Otolaryngol 1997; 117:696-703. [PMID: 9349865 DOI: 10.3109/00016489709113462] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In a retrospective study of 179 otitis-prone children and 305 controls, various possible predisposing factors for acute otitis media (AOM) were compared. The children were matched with the controls for age and sex. There were 61% boys and 39% girls in the otitis-prone group and 58% boys and 42% girls among the controls. Information about the family and living conditions, the children's illnesses, ear, nose and throat (ENT) operations and possible allergies were obtained from a questionnaire, and the children were called for a physical examination. The otitis-prone children had more middle-ear problems with pathological tympanograms and conductive hearing loss than the controls. No differences were found in bacterial colonization of the nasopharynx. Besides AOM and secretory otitis media, the otitis-prone children had more other ENT diseases and had consequently undergone more ENT operations and hospitalizations than the controls. There were no differences between the two groups regarding allergy, day care or parental smoking alone, but on comparing children with combinations of these factors there were more otitis-prone children than controls exposed, indicating an additive effect. The combination of different factors, less important separately, may for some children mean the difference between becoming otitis-prone or not.
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Affiliation(s)
- C Stenström
- Department of Oto-Rhino-Laryngology, University of Lund, Malmö University Hospital, Sweden
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Question 4 Existe-t-il une prévention possible des rhinopharyngites et otites récidivantes ? Med Mal Infect 1997. [DOI: 10.1016/s0399-077x(97)80030-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Chevalier D. [Rhinopharyngitis and recurrent acute otitis media: Risks and guidelines]. Med Mal Infect 1997; 27:478-481. [PMID: 38620247 PMCID: PMC7131805 DOI: 10.1016/s0399-077x(97)80050-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rhinopharyngitis is a common disease in the pediatric population. Acute otitis media is the most frequent complication. Eustachian tube obstruction is responsible for underaeration of the middle-car. Congestion of the respiratory mucosa and adenoid hypertropy result in persistent middle ear effusion and recurrent acute otitis media. Other predisposing factors are allergy, passive smoking, persistent middle ear effusion, young-age at first diagnosis of acute otitis media. Adenoidectomy and/or tympanostomy tubes are indicated in the treatment of recurrent acute otitis media.
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Affiliation(s)
- D Chevalier
- Hôpital Claude Huriez, Service d'ORL, place de Verdun - F-59037 Lille Cedex, France
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Abstract
The frequency of acute infectious diseases and allergy was investigated in a group of 'otitis prone' children and a control group. A total of 252 children born between 1977 and 1981, prospectively followed and with six or more episodes of acute otitis media (AOM), were defined as an 'otitis prone' group. Of the children, 61% were boys and 39% were girls. The controls were 252 children randomly chosen from the population of Malmö and matched for age and sex. The medical records for both groups from the ages of 2 to 7 years were compared. The 'otitis prone' children accounted for an average number of ambulatory visits to the ENT or Paediatric clinics of 38.8 per child, compared with 9.2 in the control group, and had been hospitalized three times more often in the ENT department than the controls, and twice as often in the Paediatric department. The 'otitis prone' children accounted for more visits to the Orthopaedic clinic than the controls, but had not been hospitalized more often in the Surgical or orthopaedic departments. The 'otitis prone' children accounted for 2-4 times as many diagnoses of rhinopharyngitis, bacterial rhinitis/sinusitis and tonsillitis as controls, and significantly more diagnosed episodes of broncho/pulmonary, gastrointestinal and urinary tract infections. There were twice as many children in the 'otitis prone' group with allergic diseases as in the control group (37% vs. 17%). The findings showed the 'otitis prone' children to be more susceptible than the controls to different acute infectious diseases.
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Affiliation(s)
- C Stenström
- Department of Oto-rhino-laryngology, University of Lund, Malmö General Hospital, Sweden
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