Abstract
ObjectiveTo determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. MethodsRetrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber‐gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. ConclusionsOtitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding.
Highlights
Otitis media with effusion (OME) is a common chronic condition and usually asymptomatic in children
This study was approved by the Institutional Review Board of Hospital das Clínicas da Faculdade de Medicina de São Paulo (1378/09). This is a retrospective study based on the analysis of medical records of infants born at HC-FMUSP
There have been many studies on OME; they mostly omit infants or newborns. This condition is a common cause of false positive result in the newborn hearing screening test.[9]
Summary
Otitis media with effusion (OME) is a common chronic condition and usually asymptomatic in children. OME is a risk factor for acute otitis media and for sleep disorders, loss of appetite and ear pain and has psychosocial impacts, which, in the long term, may result in behavioral,[1] speech and language development disorders.[2] It is characterized by middle ear inflammation, which is filled with a fluid (effusion) and with no clinical signs of infection.[3]. Its diagnosis in newborns and infants is difficult and inherent to the difficulty of performing the otoscopy in this age group, by the size of the ear canal, and due to the patient’s lack of cooperation, the presence of cerumen and the difficulty in removing it.[4] OME often goes undetected and undiagnosed because it does not have a symptomatic picture as important as acute otitis media. It can spontaneously occur due to reduced function of the eustachian tube or the result of a previous infectious process, among others.[5]
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