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Robinson M, Burgner D, Lin A, Jacoby P, Eikelboom R, Vijayasekaran S, Brennan-Jones CG. Risk of otitis media in offspring following maternal prenatal stress exposure. Int J Pediatr Otorhinolaryngol 2024; 182:112022. [PMID: 38941719 DOI: 10.1016/j.ijporl.2024.112022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/12/2024] [Accepted: 06/23/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVES There is limited but consistent evidence that suggests prenatal factors, including maternal stress, may contribute to susceptibility for otitis media. We aimed to determine the effect of multiple life stress events during pregnancy on risk of acute and recurrent otitis media in offspring at three and five years of age. METHODS Exposure data on stressful life events were collected from pregnant women in a longitudinal prospective pregnancy cohort study, at 18 and 34 weeks' gestation. We used longitudinal regression models stratified by offspring sex to examine associations between the number, type and timing of maternal prenatal stress events and the likelihood of any OM in addition to recurrent OM infection at age three and five years, adjusting for pre-specified prenatal sociodemographic and environmental confounders. RESULTS Each additional stressful life event in pregnancy was associated with increased risk of any OM at both ages (3 years: OR = 1.07, 95%CI = 1.02, 1.12; 5 years: OR = 1.07, 95%CI = 1.02, 1.12), with larger effect sizes for recurrent otitis media (3 years: OR = 1.11, 95%CI = 1.05, 1.17; 5 years: OR = 1.09, 95%CI = 1.04, 1.14). Risk of offspring otitis media did not differ with timing of stress nor by offspring sex. Specific types of stress (pregnancy and relationship problems, issues with other children) were each associated with increased risk of recurrent OM at age three and five years. CONCLUSIONS We observed a dose-response relationship between maternal stressful life events in pregnancy and the risk for offspring otitis media in the preschool years, most marked for recurrent otitis media.
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Affiliation(s)
- Monique Robinson
- Telethon Kids Institute, The University of Western Australia, Australia.
| | - David Burgner
- Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia; Department of Paediatrics, Monash University, Clayton, Australia
| | - Ashleigh Lin
- School of Population and Global Health, The University of Western Australia, Australia
| | - Peter Jacoby
- Telethon Kids Institute, The University of Western Australia, Australia
| | - Robert Eikelboom
- Ear Sciences Centre, Medical School, The University of Western Australia, Australia; Ear Science Institute Australia, Perth, Australia; Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa; Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Shyan Vijayasekaran
- Perth ENT Centre, Perth, Australia; Otolaryngology Head and Neck Surgery, Perth Children's Hospital, Perth, Australia; Medical School, The University of Western Australia, Australia
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Alaraifi AK, Alkhaldi AS, Ababtain IS, Alsaab F. Predictors of Otitis Media with Effusion Recurrence Following Myringotomy. Indian J Otolaryngol Head Neck Surg 2022; 74:4053-4058. [PMID: 36742680 PMCID: PMC9895307 DOI: 10.1007/s12070-021-02817-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/08/2021] [Indexed: 02/07/2023] Open
Abstract
Otitis media with effusion (OME) is the most common cause of acquired pediatric hearing loss. The treatment of persistent OME includes myringotomy with or without tube insertion, with a reported recurrence rate of 19.9-40%. This study aims to investigate the recurrence rate of OME and its predictors following myringotomy. A retrospective study that included 345 ears that underwent myringotomy for persistent OME in 179 pediatric patients during 2016-2018. Patients were followed for 36-48 months post myringotomy procedure to detect the recurrence rate. The study sample was divided into two groups based on recurrence status, and the groups were compared using chi-square test and independent T-test. Significant variables (p-value ≤ 0.05) were included in the logistic regression model to determine the predictors of OME recurrence after myringotomy. OME recurrence was detected in 85 ears (24.64%). The OME recurrence rate is higher in patients who underwent myringotomy alone compared to myringotomy with tube insertion (44.1% vs. 22.8%). The insertion of a tympanostomy tube decreases the recurrence rate of OME by 59.9% (OR 0.401; 95% CI 0.162-0.933). The other socio-demographic and clinical characteristics such as age, siblings, daycare attendance, passive smoking, previous acute otitis media, atopy, and adenoidectomy did not significantly influence OME recurrence (p-value > 0.05). The recurrence rate of OME following myringotomy is high. Myringotomy with tube insertion significantly decreases the recurrence rate and the need for further surgeries compared to myringotomy alone. Adenoidectomy and the patient's age have no impact on the recurrence rate of OME.
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Affiliation(s)
- Abdulaziz K. Alaraifi
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, 11426 Saudi Arabia
| | - Abdullah S. Alkhaldi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ibrahim S. Ababtain
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fahad Alsaab
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, 11426 Saudi Arabia
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Wynings EM, Jaffal H, St John R, Johnson RF, Chorney SR. Mechanical ventilation and middle ear effusions among tracheostomy-dependent children. Int J Pediatr Otorhinolaryngol 2022; 155:111062. [PMID: 35202901 DOI: 10.1016/j.ijporl.2022.111062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/28/2022] [Accepted: 02/12/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the cumulative 24-month incidence of middle ear effusion (MEE) among tracheostomy-dependent children requiring ventilatory support. METHODS A prospective longitudinal cohort study included all children under 2 years of age with a tracheostomy placed at a tertiary care children's hospital between 2015 and 2020 that obtained at least one tympanometry exam. The development of MEE, defined as a flat tympanogram with normal external canal volume, and mechanical ventilation requirement at examination were recorded. RESULTS Ninety-four children with a mean age at tracheostomy of 5.4 months (SD: 3.7) were included. During a mean follow-up of 18.3 months (SD: 14.6) (median: 14.1 months, interquartile range: 6.6-27.8), 192 tympanometry examinations were obtained with 59% (114/192) while requiring mechanical ventilation. Within 24 months after tracheostomy, 56.5% (95% CI: 48.9-64.4%) of children developed at least one MEE. Among those on mechanical ventilation, 74.0% (95% CI: 65.6-82.5%) developed MEE compared to 31.2% (95% CI: 21.4-44.0%) not on mechanical ventilation (HR: 2.97, 95% CI: 1.46-6.05, P = .003). A persistent MEE on two consecutive exams was not statistically more common for children on a ventilator (OR: 0.64, 95% CI: 0.01-6.95, P = .70). When controlling for age at exam, craniofacial syndrome, and newborn hearing test results on logistic regression, ventilator-dependence significantly predicted the presence of MEE (OR: 2.34, 95% CI: 1.18-4.68, P = .02). CONCLUSION Children with a tracheostomy were more likely to develop MEE when requiring mechanical ventilation. Clinicians should recognize this risk factor and appropriately assess for development of MEE to mitigate adverse speech and language development outcomes in this vulnerable population.
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Affiliation(s)
- Erin M Wynings
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hussein Jaffal
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, USA
| | - Rachel St John
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Romaine F Johnson
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, TX, USA
| | - Stephen R Chorney
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, TX, USA.
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Prevalence of and factors affecting otitis media with effusion in children in the region from Balkans to Caspian basin; A multicentric cross-sectional study. Int J Pediatr Otorhinolaryngol 2021; 143:110647. [PMID: 33601100 DOI: 10.1016/j.ijporl.2021.110647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/27/2021] [Accepted: 02/06/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of our study was to contribute to the literature about the prevalence of OME by conducting a research in a wide geography examining most of the associating factors together with a questionnaire. Additionally, possible effects of altitudes and latitudes, concordance between the otoscopic examination findings and tympanometric and acoustic reflex test results were evaluated in 4-7 years old children in the same season in different countries. METHODS In the randomly sampled schools from different regions of different cities where people of different scoioecomonic statuses live, 4-7 year-old children were included in the study. The results of the questionnaire covering the potential factors in OME etiology were evaluated together with the results of the otoscopic examination and tympanometry findings, and also the acoustic reflex findings to direct the interpretation in cases of low amplitude - blunted peak tympanograms which can be interpreted as a "Type B" or "Type As". All the results were gathered in the same season. RESULTS Ten centers from nine countries participated in the study. A total of 4768 children were evaluated. The frequency of OME diagnosed by otosopic examination was 22.48% (n=1072) and the diagnosis rate when otoscopic examination plus type B tympanometry were taken into account was found as 11.3% (n=539) in general population. Factors increasing the prevalence of OME were found as; mother's educational level (p=0.02), child's age (p=0.006), history of upper respiratory tract infection (p=0.001), smoking father (p=0.01), mother being a housewife or laborer (p=0.01), history of allergy (p=0.001), asthma (p=0.04), or allergy symptoms (p=0.02). No direct relationship was found between altitudes or latitudes and prevalence of OME. CONCLUSION The important affecting factors found after analyzing all of the potential risk factors in the same model are secondhand smoke exposure, low level of mother's education, mother's occupation, positive history of URTI, and age of the child being less than 7. By paying attention to the factors that increase the prevalence of OME, putting particular emphasis on the preventable ones such as smoking, education, and fighting with allergies could decrease the prevalence of this public health issue.
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Clamp PJ, De-Loyde K, Maw AR, Gregory S, Golding J, Hall A. Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children. J Laryngol Otol 2020; 134:1-12. [PMID: 33208197 DOI: 10.1017/s0022215120002182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to analyse social, health and environmental factors associated with the development of chronic otitis media by age nine. METHOD This was a prospective, longitudinal, birth cohort study of 6560 children, reviewed at age nine. Chronic otitis media defined as previous surgical history or video-otoscopic changes of tympanic membrane retraction, perforation or cholesteatoma. Non-affected children were used as the control group. RESULTS Univariate analysis demonstrated an association between chronic otitis media and otorrhoea, snoring, grommet insertion, adenoidectomy, tonsillectomy, hearing loss, abnormal tympanograms and preterm birth. Multivariate analysis suggests many of these factors may be interrelated. CONCLUSION The association between chronic otitis media and otorrhoea, abnormal tympanograms and grommets supports the role of the Eustachian tube and otitis media (with effusion or acute) in the pathogenesis of chronic otitis media. The role of snoring, adenoidectomy and tonsillectomy is unclear. Associations suggested by previous studies (sex, socioeconomic group, parental smoking, maternal education, childcare, crowding and siblings) were not found to be significant predictors in this analysis.
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Affiliation(s)
- P J Clamp
- Department of ENT, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- School of Social and Community Medicine, University of Bristol, UK
| | - K De-Loyde
- School of Social and Community Medicine, University of Bristol, UK
| | - A R Maw
- School of Social and Community Medicine, University of Bristol, UK
| | - S Gregory
- School of Social and Community Medicine, University of Bristol, UK
| | - J Golding
- School of Social and Community Medicine, University of Bristol, UK
| | - A Hall
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Life and Health Sciences, Aston University, Birmingham, UK
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Prevalence of upper respiratory tract infections in habitually snoring and mouth breathing children. Int J Pediatr Otorhinolaryngol 2018; 107:37-41. [PMID: 29501308 DOI: 10.1016/j.ijporl.2018.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/07/2018] [Accepted: 01/10/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The aim of the study was to investigate the prevalence of upper respiratory tract infections (URI) - as indicated by rhinosinusitis (RS), ear infections (EI), and antibiotic consumption - in a general pediatric population and evaluate the relationship between these conditions and habitual snoring and mouth breathing during sleep. METHODS A population-based cross-sectional study was performed in three medium-sized Polish cities from 2011 to 2015. RESULTS 4837/6963 questionnaires (69.5%) were completed, returned and analyzed. Mean age of studied group was 7.07 ± 0.72 and 7.14 ± 0.73 in girls and boys, respectively. Habitual mouth breathing during sleep (MB) was reported in 907 (18.7%) children and habitual snoring (HS) in 290 (6.0%). 230/290 (79.3%) of children with HS were also MB. Both HS and MB were more prevalent in boys than in girls (p = 0.027 and p < 0.0001, respectively) and neither was associated with BMI (p = 0.11 and p = 0.07, respectively). Habitual snoring and habitual mouth breathing were highly associated with more frequent bouts of rhinosinusitis, ear infections, and antibiotic use (p < 0.0001 for each parameter). CONCLUSIONS Higher rates of rhinosinusitis, ear infections, and antibiotic consumption were similarly associated with HS and MB. MB is over three times more prevalent in the pediatric population relative to HS, therefore it might be considered as a risk factor for URI and may be included in history of URI.
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Klopp-Dutote N, Kolski C, Strunski V, Page C. Tympanostomy tubes for serous otitis media and risk of recurrences. Int J Pediatr Otorhinolaryngol 2018; 106:105-109. [PMID: 29447881 DOI: 10.1016/j.ijporl.2018.01.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/05/2018] [Accepted: 01/10/2018] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To determine the value of tympanostomy tubes (TTs) in the management of serous otitis media (SOM) and the risk factors for SOM recurrence. METHOD This single-centre cohort study was performed in the University hospital of Amiens, France; and concerned 215 under-12 children having undergone at least one bilateral TT (Shepard grommet-type) placements for SOM. RESULTS The mean TT retention time was 10 months. SOM recurred in 79 children (62.79%) and thus required a second TT placement (bilaterally in 90% of these cases). Overall, 29.3% of the patients underwent a total of two TT placements, 5.58% underwent three placements and 0.93% underwent four placements. After their first-ever TT placement, 17 children had complications: 10 cases of otorrhoea (4.6%), 4 cases of retraction pocket (1.9%) and 3 perforations of the tympanic membrane (1.4%). At last follow-up, the most common complications were tympanosclerosis (6.9%) and perforation of the tympanic membrane (6.5%). In a multivariate analysis, the only significant risk factors for SOM recurrence were age below 48 months at the time of TT placement, and a TT retention time below 9 months. In contrast, a history of allergy, gastro-oesophageal reflux, prematurity or passive smoking were not significantly associated with recurrence. CONCLUSION Age at the time of TT placement and the TT retention time were significantly associated with SOM recurrence. The TT retention time and the number of TT placements were not associated with the risk of long-term complications.
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Affiliation(s)
| | - Catherine Kolski
- ENT and Head & Neck Surgery Department, Amiens University Hospital, France
| | - Vladimir Strunski
- ENT and Head & Neck Surgery Department, Amiens University Hospital, France
| | - Cyril Page
- ENT and Head & Neck Surgery Department, Amiens University Hospital, France.
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Kim SY, Son BS, Park HJ, Oh SH, Lee JH, Suh MH, Park MK. Impact of environmental volatile organic compounds on otitis media in children: Correlation between exposure and urinary metabolites. Int J Pediatr Otorhinolaryngol 2017; 93:157-162. [PMID: 28109489 DOI: 10.1016/j.ijporl.2016.12.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 12/23/2016] [Accepted: 12/24/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Volatile organic compounds (VOCs) induce inflammatory responses. Tobacco smoke contains numerous VOCs and is a risk factor for otitis media effusion (OME); however, no previous studies have investigated the association between VOCs and OME. OBJECTIVES We used urinary metabolites and exposure to environmental risk factors to investigate the association between VOC and polycyclic aromatic hydrocarbon exposure and recurrent OME in children. METHODS Children with recurrent OME who visited the Otorhinolaryngology Department of Seoul National University Hospital between November 2014 and June 2015 were prospectively enrolled in the study. Recurrent OME was defined as more than two OME episodes over a 6-month period lasting longer than 2 months. The control group consisted of children without OME in the last year. Demographic information, including age, sex, and previous medical history was obtained, and endoscopic examinations of the tympanic membrane were performed. Urinary concentrations of 1-hydroxypyrene, 2-naphthol, hippuric acid, trans, trans-muconic acid (t,t-MA), mandelic acid, phenyl glyoxylic acid, and methyl hippuric acid were analyzed using high-performance liquid chromatography/tandem mass spectroscopy. Environmental factors assessed included house type, age, renovations, the presence of furniture <6 months old, proximity to a road, and exposure to passive smoking. RESULTS We enrolled 11 children with OME and 39 controls. Age and sex did not differ between groups. Exposure to passive smoking was significantly more common in the OME group than in the controls (P < 0.001). Urinary concentrations of t.t.-MA were significantly higher in the OME group (126.33 μg/g cr) than in controls (52.661 μg/g cr; P = 0.003). Other metabolites including 1-hydroxypyrene, 2-naphthol, hippuric acid, mandelic acid, phenyl glyoxylic acid, and methyl hippuric acid did not demonstrated significant relation with the OME. CONCLUSIONS Levels of t,t-MA, a biomarker of benzene exposure, were significantly higher in the OME group than in controls. Passive smoking was significantly more common in the OME group. Our findings suggest that high t,t-MA levels which were probably originated from passive smoking and other pollutants could be indicative OME in children.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Bu-Soon Son
- Department of Environment Health Science, Soonchunhyang University, South Korea
| | - Hee-Jin Park
- Department of Environment Health Science, Soonchunhyang University, South Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Myung-Hwan Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea.
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Kørvel-Hanquist A, Koch A, Niclasen J, Dammeye J, Lous J, Olsen SF, Homøe P. Risk Factors of Early Otitis Media in the Danish National Birth Cohort. PLoS One 2016; 11:e0166465. [PMID: 27851778 PMCID: PMC5113063 DOI: 10.1371/journal.pone.0166465] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/28/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess risk factors of otitis media (OM) in six-months-old children. METHOD The sample consisted of 69,105 mothers and their children from the Danish National Birth Cohort. The women were interviewed twice during pregnancy and again 6 months after birth. The outcome "one or more" maternal reported episodes of OM at age six months. In total 37 factors were assessed, covering prenatal, maternal, perinatal and postnatal factors. RESULTS At age six months 5.3% (95% CI 5.1-5.5) of the children had experienced one or more episodes of OM. From the regression analysis, 11 variables were associated with a risk of OM. When a Bonferroni correction was introduced, gender, prematurity, parity, maternal age, maternal self-estimated health, taking penicillin during pregnancy, and terminating breastfeeding before age six months, was associated with a risk of early OM. The adjusted ORs of OM for boys versus girls was 1.30 (95% CI 1.18-1.44). The OR having one sibling versus no siblings was 3.0 (95% CI 2.64-3.41). If the woman had been taking penicillin during pregnancy, the OR was 1.35 (95% CI 1.15-1.58). Children born before 38th gestational week had an increased OR for early OM of 1.49 (95% CI 1.21-1.82). Children of young women had an increased OR of early OM compared to children of older women. Additionally, children of women who rated their own health low compared to those rating their health as high, had an increased OR of 1.38 (95% CI 1.10-1.74). Finally, children being breastfeed less than 6 months, had an increased OR of 1.42 (95% CI 1.28-1.58) compared to children being breastfeed beyond 6 months. CONCLUSION These findings indicate that prenatal factors are of less importance regarding early OM before the age of six months. Postnatal risk factors seem to pose the main risk of early OM.
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Affiliation(s)
- Asbjørn Kørvel-Hanquist
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
- * E-mail:
| | - Anders Koch
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - Janni Niclasen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Center for Collaborative Health, Aarhus University, Aarhus, Denmark
| | - Jesper Dammeye
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Lous
- Research Unit for General Practice Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sjurdur Frodi Olsen
- Department of Epidemiology Research, Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
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Amani S, Yarmohammadi P. Study of Effect of Household Parental Smoking on Development of Acute Otitis Media in Children Under 12 Years. Glob J Health Sci 2015; 8:81-8. [PMID: 26652088 PMCID: PMC4877218 DOI: 10.5539/gjhs.v8n5p81] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/09/2015] [Indexed: 02/02/2023] Open
Abstract
Background and Aim: High prevalence of acute otitis media (AOM) in children represents a combination of the factors developing eustachian tube dysfunction and higher susceptibility to upper respiratory tract infections in children. This disease is relatively prevalent in Iran and much cost is spent annually to treat it. This study investigated the effect of household parental smoking on development of AOM in children under 12 years. Methods: In this case-control study all patients under the age of 12 years with AOM referring an ENT clinic in Shahrekord, southwest Iran between April 2014 and August 2014 were enrolled by convenience sampling. This study included two groups. Group 1 (G1) was exposed to parental smoking at home and group 2 (G2) was not. For the patients, a questionnaire of demographic data such as age and gender, the disease symptoms, parents’ education level, history of respiratory diseases, allergy, surgery (adenoidectomy, tonsillectomy, and tympanostomy), and household smoking was filled out by a specialist through interview. Results: In this study, 250 children 1-12 years with AOM, 145 in G1 and 105 in G2, were investigated. Clinical symptoms including fever (p=0.001) and hearing loss (p=0.014) were significantly more frequent in the children of G1 than G2, and otalgia, discharge, and tinnitus were similarly frequent in the two groups (p>0.05). Also, eardrum inflammation was more frequent in G1 than G2, with no significant difference (p>0.05). AOM was reported 70.3% in G1, which was higher than 26.7% reported in G2 (p=0.001). Also, asthma, recurrent ear pain, enlargement of the tonsils, and respiratory problems were more frequent in G1 than G2 (p<0.05). Conclusions: Parental smoking was a risk factor for AOM and respiratory problems and therefore the parents are recommended to avoid smoking near children to reduce the likelihood of AOM development and exacerbation in children.
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Affiliation(s)
- Soroush Amani
- Department of Otolaryngology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
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Association of Gestational Age at Birth with Reasons for Subsequent Hospitalisation: 18 Years of Follow-Up in a Western Australian Population Study. PLoS One 2015; 10:e0130535. [PMID: 26114969 PMCID: PMC4482718 DOI: 10.1371/journal.pone.0130535] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 05/22/2015] [Indexed: 12/02/2022] Open
Abstract
Background Preterm infants are at a higher risk of hospitalisation following discharge from the hospital after birth. The reasons for rehospitalisation and the association with gestational age are not well understood. Methods This was a retrospective birth cohort study of all live, singleton infants born in Western Australia between 1st January 1980 and 31st December 2010, followed to 18 years of age. Risks of rehospitalisation following birth discharge by principal diagnoses were compared for gestational age categories (<32, 32–33, 34–36, 37–38 weeks) and term births (39–41weeks). Causes of hospitalisations at various gestational age categories were identified using ICD-based discharge diagnostic codes. Results Risk of rehospitalisation was inversely correlated with gestational age. Growth-related concerns were the main causes for rehospitalisation in the neonatal period (<1 month of age) for all gestational ages. Infection was the most common reason for hospitalisation from 29 days to 1 year of age, and up to 5 years of age. Injury-related hospitalisations increased in prevalence from 5 years to 18 years of age. Risk of rehospitalisation was higher for all preterm infants for most causes. Conclusions The highest risks of rehospitalisation were for infection related causes for most GA categories. Compared with full term born infants, those born at shorter GA remain vulnerable to subsequent hospitalisation for a variety of causes up until 18 years of age.
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Park M, Lee JS, Lee JH, Oh SH, Park MK. Prevalence and risk factors of chronic otitis media: the Korean National Health and Nutrition Examination Survey 2010-2012. PLoS One 2015; 10:e0125905. [PMID: 25978376 PMCID: PMC4433353 DOI: 10.1371/journal.pone.0125905] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 03/21/2015] [Indexed: 02/02/2023] Open
Abstract
Background The performance of nationwide studies of chronic otitis media (COM) in adults has been insufficient in Korea. We evaluated the prevalence and risk factors of COM in Korea. Methods This study was conducted using data from the fifth Korean National Health and Nutrition Examination Survey (n = 23,621). After excluding the subjects under 20 year old and suffered from cancers, 16,063 patients were evaluated for COM. Participants underwent a medical interview, physical examination, endoscopic examination, and blood and urine test. COM was diagnosed by trained residents in the Department of Otorhinolaryngology using an ear, nose, and throat questionnaire and otoendoscopy findings. Data on the presence and absence of COM were collected. Multivariate logistic regression analyses were performed to identify its risk factors. Results Of the 16,063 participants aged above 20 year old, the weighted prevalence of COM was 3.8%. In the multivariate analyses, the following factors showed high odds ratios (ORs) for COM: pulmonary tuberculosis (adjusted OR, 1.78; 95% confidence interval [CI], 1.06-3.01), chronic rhinosinusitis (adjusted OR, 1.87; 95% CI, 1.17-2.98), mild hearing impairment (adjusted OR, 1.95; 95% CI, 1.34-2.85), moderate hearing impairment (adjusted OR, 4.00; 95% CI, 2.21-7.22), tinnitus (adjusted OR, 1.82; 95% CI, 1.34-2.49), increased hearing thresholds in pure tone audiometry in the right ear (adjusted OR, 1.02; 95% CI, 1.01-1.03), and left ear (adjusted OR, 1.03; 95% CI, 1.02-1.04). The following factors showed low odds ratios for COM: hepatitis B (adjusted OR, 0.28; 95% CI, 0.08-0.94) and rhinitis (adjusted OR, 0.60; 95% CI, 0.42-0.88). In addition, high levels of vitamin D, lead, and cadmium, EQ-5D index; and low red blood cell counts were associated with development of COM (Student’s t-test, P < 0.01). Conclusions Our population-based study showed that COM is not rare in Korea, and its development may be associated with various host and environmental factors. Further research on its relationships and the pathogenesis are needed.
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Affiliation(s)
- Mina Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Medical Center, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Seung Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
- * E-mail:
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13
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Brennan-Jones CG, Whitehouse AJ, Park J, Hegarty M, Jacques A, Eikelboom RH, Swanepoel DW, White JD, Jamieson SE. Prevalence and risk factors for parent-reported recurrent otitis media during early childhood in the Western Australian Pregnancy Cohort (Raine) Study. J Paediatr Child Health 2015; 51:403-9. [PMID: 25303240 DOI: 10.1111/jpc.12741] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 01/01/2023]
Abstract
AIM To describe the prevalence and risk factors of recurrent otitis media (rOM) in an urban Australian population at 3 years of age. METHODS Cross-sectional examination of prevalence and risk factors of rOM in 2280 participants from the Raine Study enrolled from public and private hospitals in Perth, Western Australia, between 1989 and 1991. Parental report questionnaires at 3 years of age were used for rOM identification, with secondary confirmation by otoscopic examination at 1, 2 or 3 years of age. RESULTS The prevalence of parent-reported rOM was 26.8% (611/2280) and 5.5% (125/2280) for severe rOM in the Study. Independent associations were found between rOM and the presence of older siblings, attendance at day care and the introduction of other milk products at ≤4 months of age. Independent associations for severe rOM were the presence of allergies and attendance at day care. CONCLUSIONS Prevalence rates of rOM within the Raine Study children are similar to a number of other known cohorts. Parity, presence of allergies, attendance at day care and introduction of other milk products at ≤4 months are highlighted as specific risk factors for rOM in this population and presence of allergies and attendance at day care being risk factors for severe rOM. Diagnosis of rOM by parent report and the delay between data collection and reporting are limitations of this study. However, as there is very limited data on OM in urban, non-Indigenous Australian children, this study improves our understanding of OM for this group.
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Affiliation(s)
- Christopher G Brennan-Jones
- Division of Speech and Hearing Sciences, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom; Ear Science Institute Australia, Perth, Western Australia, Australia; Ear Sciences Centre, School of Surgery, The University of Western Australia, Perth, Western Australia, Australia
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14
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Khattab M, Cannon-Heinrich C, Bizzarro MJ. Ear drainage and the role of sepsis evaluations in the neonatal intensive care unit. Acta Paediatr 2014; 103:732-6. [PMID: 24635016 DOI: 10.1111/apa.12636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/27/2014] [Accepted: 03/12/2014] [Indexed: 11/28/2022]
Abstract
AIM To design and implement an intervention to reduce ear drainage and subsequent sepsis evaluation and treatment in the neonatal intensive care unit. METHODS From 2008 to 2011, we observed an increase in the rates of ear drainage warranting investigation. Data collection was performed from 1991 to 2013 on 50 cases. Preliminary analysis revealed an association between timing of endotracheal tube tape changes and onset of drainage. We speculated that pooling of anti-adhesive solution into the external auditory canal was precipitating an inflammatory process. Unit-wide education was conducted to protect the ears during tape removal. Post-initiative rates of drainage were collected and compared with pre-initiative rates. RESULTS Median gestational age and birthweight were 26 weeks and 754 g, respectively. In 64% of cases, an anti-adhesive solution was used on the face within 48 h of the onset of drainage. Sepsis evaluation was performed in 68% of cases. Rates of ear drainage peaked from 2008 to 2011 at 9.18 per 1000 admissions when a new anti-adhesive product was used, declining to 0.66 post-initiative (rate difference: -8.52; 95% CI: -12.00, -5.03). CONCLUSION Protecting the ear from anti-adhesive solutions during tape removal may reduce rates of noninfectious ear drainage and limit unnecessary interventions.
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Affiliation(s)
- Mona Khattab
- Department of Pediatrics; Baylor College of Medicine; Houston TX USA
| | | | - Matthew J. Bizzarro
- Department of Pediatrics; Yale University School of Medicine; New Haven CT USA
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15
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Zhang Y, Xu M, Zhang J, Zeng L, Wang Y, Zheng QY. Risk factors for chronic and recurrent otitis media-a meta-analysis. PLoS One 2014; 9:e86397. [PMID: 24466073 PMCID: PMC3900534 DOI: 10.1371/journal.pone.0086397] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 12/09/2013] [Indexed: 11/30/2022] Open
Abstract
Risk factors associated with chronic otitis media (COM) and recurrent otitis media (ROM) have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database) from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs) could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13–1.64; P = 0.001). An upper respiratory tract infection (URTI) significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13–13.89; P<0.00001). Snoring appeared to be a significant risk factor for COM/ROM (OR, 1.96; 95% CI, 1.78–2.16; P<0.00001). A patient history of acute otitis media (AOM)/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06–116.44; P = 0.04). Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02–1.89 P = 0.04). Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11–13.15; P = 0.03). Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria.
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Affiliation(s)
- Yan Zhang
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Min Xu
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
- * E-mail:
| | - Jin Zhang
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Lingxia Zeng
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Yanfei Wang
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
- Departments of Otolaryngology-HNS and Genetics, and the Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai, Shandong, China
| | - Qing Yin Zheng
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
- Departments of Otolaryngology-HNS and Genetics, and the Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai, Shandong, China
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Huang Q, Zhang Z, Zheng Y, Zheng Q, Chen S, Xu Y, Ou Y, Qiu Z. Hypoxia-inducible factor and vascular endothelial growth factor pathway for the study of hypoxia in a new model of otitis media with effusion. Audiol Neurootol 2012; 17:349-56. [PMID: 22907120 DOI: 10.1159/000341163] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 06/18/2012] [Indexed: 02/04/2023] Open
Abstract
The hypoxia-inducible factor and vascular endothelial growth factor (HIF-VEGF) pathway in hypoxic conditions of the middle ear due to dysfunction of the eustachian tube is still unknown, but it is considered as one pathogenetic mechanism in otitis media. This study was designed to investigate the possible involvement of the HIF-VEFG pathway in otitis media with effusion induced by dysfunction of the eustachian tube. We adopted a soft palate approach to obstruct the orifice of the eustachian tube to establish otitis media in a rat model. Auditory evoked brainstem response and tympanometry were used as hearing function tests, hypoxia-related factors were examined by reverse transcriptase polymerase chain reaction (RT-PCR). The expression of hypoxia-related proteins was detected by Western blot and immunostaining. The model of otitis media with effusion was successfully induced by cauterizing the orifice of the eustachian tube. RT-PCR showed up-regulation of hypoxia-related factors in cauterized ears. Western blot and immunostaining showed that the expression of hypoxia-related proteins in cauterized ears was increased. Hypoxia-induced vascular proliferation and an increase in permeability may be one pathogenetic mechanism of otitis media due to dysfunction of the eustachian tube.
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Affiliation(s)
- Qiuhong Huang
- Department of Otolaryngology-HNS, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, PR China
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Yilmaz G, Caylan ND, Karacan CD. Effects of Active and Passive Smoking on Ear Infections. Curr Infect Dis Rep 2012; 14:166-174. [PMID: 22302576 DOI: 10.1007/s11908-012-0239-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Otitis media (OM) is one of the most frequent diseases in young children, causing to visit a physician, and also the most common indication for antibiotic prescription. The peak incidence and prevalence of OM is 6 to 18 months of age. In children, second-hand smoke (SHS) exposure is associated with upper and lower respiratory tract infections, such as acute otitis media (AOM), pneumonia, and bronchitis. Despite the overwhelming evidence of the role of SHS exposure on infant health, a very high proportion of children still continue to be exposed. This important relationship between all kinds of smoking and poor health may not be appreciated universally. With this article, we aim to review tobacco smoke exposure and OM connection. How this exposure may cause OM especially in young children? What can be done to prevent and to reduce the harmfull effects of tobacco smoking?
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Affiliation(s)
- Gonca Yilmaz
- Dr. Sami Ulus Training and Research Hospital, Babür Caddesi No: 44, (06080), Altındağ, Ankara, Turkey,
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Macintyre EA, Karr CJ, Koehoorn M, Demers P, Tamburic L, Lencar C, Brauer M. Otitis media incidence and risk factors in a population-based birth cohort. Paediatr Child Health 2011; 15:437-42. [PMID: 21886448 DOI: 10.1093/pch/15.7.437] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2009] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Otitis media is the main reason young children receive antibiotics and is the leading reason for physician visits. OBJECTIVE To characterize the incidence, recurrence and risk factors for otitis media in a population-based birth cohort. METHODS All children born in southwestern British Columbia during 1999 to 2000 were followed until the age of three years. Otitis media was defined using The International Classification of Diseases, Ninth Revision coding of physician visits, and linked with antibiotic prescription data. Information on sex, birth weight, gestational age, Aboriginal status, maternal age, older siblings, maternal smoking during pregnancy, breastfeeding initiation, neighbourhood income, female education and rural residence were obtained from vital statistics, birth hospitalizations, perinatal registry and census data. RESULTS Complete risk factor information was available for 50,474 children (86% of all births). Nearly one-half of the children (48.6%) had one or more physician visits for otitis media during follow-up, and 3952 children (7.8%) met the definition for recurrent otitis media. Of the children with at least three visits during follow-up (n=7571), 73% had their initial visit during the first year of life. Aboriginal status, maternal age younger than 20 years, male sex and older siblings were the strongest risk factors identified in the adjusted conditional logistic regression models. DISCUSSION The present study established a population-based birth cohort by linking multiple administrative databases to characterize the incidence of and risk factors for otitis media. Although the incidence of otitis media is generally low in southwestern British Columbia, important risk factors continue to be young maternal age, mothers who smoke during pregnancy and children with Aboriginal ancestry.
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Affiliation(s)
- Elaina A Macintyre
- School of Environmental Health, University of British Columbia, Vancouver, British Columbia
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19
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Yang B, Tian C, Zhang ZG, Han FC, Azem R, Yu H, Zheng Y, Jin G, Arnold JE, Zheng QY. Sh3pxd2b mice are a model for craniofacial dysmorphology and otitis media. PLoS One 2011; 6:e22622. [PMID: 21818352 PMCID: PMC3144925 DOI: 10.1371/journal.pone.0022622] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Accepted: 06/26/2011] [Indexed: 11/18/2022] Open
Abstract
Craniofacial defects that occur through gene mutation during development increase vulnerability to eustachian tube dysfunction. These defects can lead to an increased incidence of otitis media. We examined the effects of a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) on the progression of otitis media and hearing impairment at various developmental stages. We found that all mice that had the Sh3pxd2bnee mutation went on to develop craniofacial dysmorphologies and subsequently otitis media, by as early as 11 days of age. We found noteworthy changes in cilia and goblet cells of the middle ear mucosa in Sh3pxd2bnee mutant mice using scanning electronic microscopy. By measuring craniofacial dimensions, we determined for the first time in an animal model that this mouse has altered eustachian tube morphology consistent with a more horizontal position of the eustachian tube. All mutants were found to have hearing impairment. Expression of TNF-α and TLR2, which correlates with inflammation in otitis media, was up-regulated in the ears of mutant mice when examined by immunohistochemistry and semi-quantitative RT-PCR. The mouse model with a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) mirrors craniofacial dysmorphology and otitis media in humans.
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Affiliation(s)
- Bin Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Cong Tian
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Zhi-guang Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- * E-mail: (QYZ); (ZgZ)
| | - Feng-chan Han
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Rami Azem
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Heping Yu
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ye Zheng
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ge Jin
- School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - James E. Arnold
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Qing Y. Zheng
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (QYZ); (ZgZ)
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Zanchetta S, Resende LADL, Bentlin MR, Rugulo LM, Trindade CEP. Conductive hearing loss in children with bronchopulmonary dysplasia: a longitudinal follow-up study in children aged between 6 and 24 months. Early Hum Dev 2010; 86:385-9. [PMID: 20554131 DOI: 10.1016/j.earlhumdev.2010.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 05/04/2010] [Accepted: 05/05/2010] [Indexed: 10/19/2022]
Abstract
AIMS To determine the occurrence of isolated and recurrent episodes of conductive hearing loss (CHL) during the first two years of life in very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD). STUDY DESIGN, SUBJECTS AND OUTCOME MEASURES: In a longitudinal clinical study, 187 children were evaluated at 6, 9, 12, 15 18 and 24 months of age by visual reinforcement audiometry, tympanometry and auditory brain response system. RESULTS Of the children with BPD, 54.5% presented with episodes of CHL, as opposed to 34.7% of the children without BPD. This difference was found to be statistically significant. The recurrent or persistent episodes were more frequent among children with BPD (25.7%) than among those without BPD (8.3%). The independent variables that contributed to this finding were small for gestational age and a 5 min Apgar score. CONCLUSIONS Recurrent CHL episodes are more frequent among VLBW infants with BPD than among VLBW infants without BPD.
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Affiliation(s)
- Sthella Zanchetta
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto-University of São Paulo, Ribeirão Preto, SP, Brazil.
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21
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Yaman H, Yilmaz S, Guclu E, Subasi B, Alkan N, Ozturk O. Otitis media with effusion: recurrence after tympanostomy tube extrusion. Int J Pediatr Otorhinolaryngol 2010; 74:271-4. [PMID: 20044147 DOI: 10.1016/j.ijporl.2009.11.035] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 11/25/2009] [Accepted: 11/29/2009] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The incidence rate of recurrence of otitis media with effusion (OME) in children after tympanostomy tube extrusion and the relationship between recurrence and tube retention time was investigated. Also relationship between recurrence rate and initial age of tube insertion was analysed. STUDY DESIGN A retrospective case series of patients who had tympanostomy tube insertion. METHODS A total of 91 children (169 ears) were reviewed. Ears of children divided into three groups according to retention time of tympanostomy tubes. Group I: tympanostomy tube retention time less than 6 months. Group II: tympanostomy tube retention time 6 months to 12 months. Group III: tympanostomy tube retention time 12 months or more. RESULTS OME recurrence rate after tube extrusion was 20.7% in the study. The longer the tympanostomy tube retention time was the lower was the recurrence rate of OME. The comparison of the three groups indicated that recurrence rates were higher in group I (36.54%), than in group II (17.74%) and in group III (9.1%). There were statistically significant differences in recurrence rates between group I and group III, and between group I and II (p<0.05, p<0.05). However, the difference in recurrence rates between group II and group III was statistically not significant (p>0.05). In the preschool age group and school age group, the recurrence rates were 5.5% and 15.4%, respectively. There was no significant difference between these two groups (p>0.05). OME recurrence was observed in 9.9% of males and in 11% of females. There was no significant difference in recurrence rates between males and females (p>0.05). CONCLUSION After extrusion of tympanostomy tube, children should be followed-up regularly for recurrence of OME. The shorter the retention time of tympanostomy tubes was the higher was the recurrence rate. For the treatment of OME the ideal type of tubes should have the lowest complication and recurrence rates. Further studies are needed to ascertain the relationship between the incidence of OME and optimal tympanostomy tubes duration of tube stay in tympanic membrane. Therefore, new studies with larger series are necessary to investigate the correlation between the recurrence rates and different tympanostomy tubes after extrusion of tubes.
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Affiliation(s)
- Huseyin Yaman
- Duzce University Duzce Medical Faculty, Department of Otorhinolaryngology, Duzce, Turkey.
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22
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Daly KA, Hoffman HJ, Kvaerner KJ, Kvestad E, Casselbrant ML, Homoe P, Rovers MM. Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media. Int J Pediatr Otorhinolaryngol 2010; 74:231-40. [PMID: 19836843 DOI: 10.1016/j.ijporl.2009.09.006] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 09/03/2009] [Indexed: 11/19/2022]
Abstract
The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute and chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.
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Affiliation(s)
- Kathleen A Daly
- Department of Otolaryngology and Division of Epidemiology, University of Minnesota, Minneapolis, MN 55435, USA.
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Bentdal YE, Håberg SE, Karevold G, Stigum H, Kvaerner KJ, Nafstad P. Birth characteristics and acute otitis media in early life. Int J Pediatr Otorhinolaryngol 2010; 74:168-72. [PMID: 19959246 DOI: 10.1016/j.ijporl.2009.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 10/30/2009] [Accepted: 11/03/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess whether preterm birth and low birth weight were associated with single and recurrent episodes of acute otitis media (AOM) the first 18 months of life. METHODS The study population consisted of 33,192 children in the Norwegian Mother and Child Cohort, conducted at the Norwegian Institute of Public Health. The majority of all pregnant women in Norway were invited to participate and the response rate was 44%. Participating women received questionnaires during pregnancy and when the child was 6 and 18 months. Main outcome measures were maternal reports of AOM at ages 6, 11 and 18 months. Information on birth weight and gestational age was obtained from the Medical Birth Registry of Norway. Regression analyses were performed controlling for a variety of potential confounders. RESULTS Preterm birth was slightly associated with both single and recurrent episodes of AOM the first 18 months of age. The adjusted relative risk (aRR) for having any episode of AOM was 1.37, 95%CI (1.12-1.68) if born before week 33, and the aRR for having recurrent AOM was 1.34, 95%CI (1.01-1.77) if born in weeks 33-36 (reference group: >or=37 weeks). A corresponding tendency was not found for low birth weight. CONCLUSIONS The finding indicates a modest increased risk of having AOM in children born preterm, and preterm birth seems to be more important than low birth weight in determining risk of having AOM in early life.
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Affiliation(s)
- Yngvild E Bentdal
- Faculty Division of Akershus University Hospital, University of Oslo, Norway.
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Falagas ME, Mourtzoukou EG, Vardakas KZ. Sex differences in the incidence and severity of respiratory tract infections. Respir Med 2007; 101:1845-63. [PMID: 17544265 DOI: 10.1016/j.rmed.2007.04.011] [Citation(s) in RCA: 201] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Revised: 02/23/2007] [Accepted: 04/16/2007] [Indexed: 01/15/2023]
Abstract
Sex is a significant epidemiological factor for several diseases. However, the role of sex in the development and outcome of various infections has not been extensively studied with the notable exception of urinary tract infections. We searched in the PubMed database to identify articles that could provide relevant data regarding sex differences in the incidence and severity of respiratory tract infections (RTIs). We extracted data from 84 relevant studies that provided information regarding sex differences in the incidence and severity of RTIs. Females are more commonly affected with infections of the upper respiratory tract, specifically sinusitis, tonsillitis, and otitis externa. On the other hand, males are more commonly affected with otitis media, croup, and most important, lower RTIs. It is also evident from the reviewed evidence that the course of most RTIs is more severe in males than in females, leading to higher mortality in males, especially in community-acquired pneumonia. In conclusion, the available data suggest that males are more susceptible than females to most types of RTIs in all age groups (adults and children). Overall, it seems that males develop RTIs more frequently than females, except for sinusitis, otitis externa, and probably tonsillitis. Anatomic, lifestyle, behavioural, and socioeconomic differences between males and females may explain the observed findings. The role of sex hormones in the regulation of the immune system may also contribute to the reported sex differences in the incidence and severity of the various types of RTIs, especially in adolescents and adults.
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Affiliation(s)
- Matthew E Falagas
- Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Greece.
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