Risk Factors For Otitis Media Research Articles

Identification of common bacterial etiologic agents, antimicrobial susceptibility pattern & associated risk factors of Otitis media among pediatric patients of ENT Center of Orotta National Referral Hospital

Identification of common bacterial etiologic agents, antimicrobial susceptibility pattern & associated risk factors of Otitis media among pediatric patients of ENT Center of Orotta National Referral Hospital

Risk Factors for Otitis Media with Effusion in Preschool and School Children in Calabar Municipality.

Predisposing factors for otitis media with effusion are multifactorial, ranging from genetic and anatomical abnormalities to environmental factors and inflammation of the nose and adjacent structures. The study determined the risk factors for otitis media with effusion (OME) among children in Calabar Municipality. This was a descriptive, cross-sectional, community-based study including children aged 1-10 years randomly selected from government and privately owned daycares, nurseries (preschool), and primary schools. The risk factors assessed included upper respiratory tract infection, allergic rhinitis, adenoid enlargement, acute otitis media, recurrent acute otitis media parental educational level, overcrowding (four children sleeping in a room), duration of breastfeeding, cleft palate, and Down's syndrome. Allergic rhinitis was diagnosed when a child had at least two of the rhinological symptoms: nasal congestion, running nose, sneezing, itching of the eye or nose, and at least one of the following: history of allergy, family history of allergy, and positive history of asthma. The questionnaire was the research instrument used to assess the risk factors for OME. OME diagnosis was made with otoscopy and tympanometry. Data were collected and analyzed with IBM SPSS version 25, and a P value <0.05 was considered statistically significant. A total of 24 daycare pupils, 141 nursery pupils, and 155 primary pupils were recruited into the study. The prevalence of otitis media with effusion was more in younger children than in older children and the relationship was statistically significant (P < 0.001). Female children were more statistically affected than male children (P = 0.007). Children with allergic rhinitis accounted for a higher proportion of those with OME than those without allergic rhinitis (26.7% vs. 11.6%), and the difference was statistically significant (P = 0.007). The association between OME and upper respiratory tract infection, acute otitis media, and recurrent acute otitis media was not statistically significant (P > 0.05). Multivariate binary logistic regression was used to identify predictors for the otitis media with effusion. There are many endogenous and exogenous risk factors for OME, but notable risk factors in our study were age 1-2 years, female sex, and allergic rhinitis.

Risk Factors for Chronic and Recurrent Otitis Media in Children: A Review Article.

Otitis media is an inflammation of the mucous membrane of the middle ear, which includes mastoid air cells, the middle ear cavity, the Eustachian tube, and the mastoid antrum. Otitis media can be either acute, less than six weeks, or chronic, which lasts for more than six weeks. Recurrent otitis media refers to three episodes of the disease occurring within six months or four episodes within one year. There are many risk factors for otitis media among children; however, some of such factors may vary based on the type of otitis media. To highlight the risk factors of chronic and recurrent otitis media in pediatrics. Scientific databases were used to search for articles related to our objective. Various terms were used for the search process. The types of articles included in our review were original articles, review articles, meta-analyses, and systematic reviews written in the English language and concerned with our subject. The topic was discussed under four main titles; the first overviewed the prevalence and risk factors of otitis media, the second title discussed chronic otitis media and its risk factors, the third title discussed recurrent otitis media and its risk factors, and the last title discussed the risk factors of both chronic and recurrent otitis media. There are various risk factors for chronic and recurrent otitis media, and they include allergy, passive smoking, male gender, and snoring. Also, genetics may have a common role, but this needs further investigation.

Relevance of cleft palatal width in short-term otologic outcomes.

Children with cleft palate are at increased risk for Eustachian tube dysfunction (ETD) and conductive hearing loss from chronic otitis media. While it has been proposed that the severity of ETD is related to the severity of cleft palate, data are lacking to support this hypothesis. An improved understanding of the relevance of cleft width may have prognostic value that could inform decisions on the timing of tympanostomy tube placement and choice of tympanostomy tube design. The objective of this study was to assess severity of ETD in children with narrow, moderate, and wide cleft palate, with examination of hearing outcomes, number of tympanostomy procedures, and incidence of otologic complications. Retrospective chart review was conducted on 58 patients with primary palatoplasty performed at a single academic medical center from January 1, 2016-December 31, 2019. The primary outcome was the number of otologic procedures performed after the initial palatoplasty. Secondary outcomes included audiometric findings, number of tympanostomy tube placements, presence of effusion at the time of myringotomy, and occurrence of any postoperative otologic complication. Outcomes were compared for patients with narrow (<10mm), moderate (10-15mm), and wide (>15mm) cleft palate. Analysis included consideration of cleft palatal morphology (Veau I - IV), presence of Robin sequence or syndromes, and risk factors for otitis media. Patients with moderate and wide cleft palate underwent higher mean numbers of otologic procedures [narrow: 1.3 (95% confidence interval [CI] 0.9, 1.7); moderate: 1.6 (95% CI 1.1, 2.1); wide: 1.8 (95% CI 1.2, 2.4)]. Moderate and wide cleft palate were less likely to have normal hearing after their first tympanostomy (narrow: 50%, 10/20; moderate: 25%, 6/24; wide: 36%, 5/14). Patients with a wide cleft palate had a shorter median time between first and second tympanostomy procedures (median, IQR; narrow: 27.0, 20.8-35.7; moderate 20.4, 16.3-25.9; wide 17.3, 11.5-23.4). Our findings suggest that patients with wider cleft palate may be more susceptible to severe ETD. Further large-scale study may help to allow for more informed and personalized clinical decision making for management of cleft palate, incorporating cleft width for prognosis of risks for persistent middle ear dysfunction.

Prevalence and risk factors of otitis media with effusion in children with obstructive sleep apnea.

The aim of this study was to investigate the correlation between obstructive sleep apnea (OSA) and otitis media with effusion (OME) in Chinese children and identify risk factors for OME to support the development of standardized diagnostic and treatment methods. Clinical data of 1,021 children with OSA admitted to our hospital between January 2019 and December 2020 were collected. The prevalence of OME was assessed based on age groups and different grades of adenoid hypertrophy (AH). Multivariate logistic regression was performed to determine risk factors for OME in this population. Among the patients, only 73 (6.15%) reported hearing loss as the main complaint, while 178 (17.43%) were diagnosed with OME after the examination. Acoustic immittance showed higher detection rates for OME compared to those of otoscopy and pure tone audiometry. In addition, the incidence of OME did not increase with AH grade but was higher in children with OSA with AH grade IV. Multivariate regression analysis showed that the younger age group (2-5 years), AH grade IV, nasal inflammatory disease, and passive smoking were significant risk factors for OSA and OME. However, sex, age of 6-12 years, and presence of chronic tonsillitis/tonsillar hypertrophy had no significant impact on the prevalence of OME. OME is highly prevalent in children with OSA. Clinicians should be vigilant in diagnosing OME, should conduct routine audiological examinations, and actively screen for middle ear fluid in all children with OSA, especially in younger children (2-5 years) with nasal mucosa inflammation and a history of passive smoking. This will help improve the detection rate of OME, as early intervention is paramount for preventing complications.

Prevalance And Associated Risk Factor For Otitis Media Among Children Aged 0-5 Years In Hiran Region

Prevalance And Associated Risk Factor For Otitis Media Among Children Aged 0-5 Years In Hiran Region

Risk factors of otitis media with effusion

Risk factors of otitis media with effusion

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy.

This study aimed to explore whether children with AH have a higher obesity prevalence and analyze the risk factors for otitis media with effusion(OME) in AH children. AH patients aged 3-12 years old that were hospitalized in our hospital for adenoidectomy from June 2020 to September 2022 were included in this study. Height and weight were measured to calculate the body mass index, weight for height and weight z-score to evaluate the development of AH children. Propensity score matching was applied to minimize patient selection bias and adjust for confounding factors to analyze the risk factors for OME in children with AH. A total of 887 children with AH were enrolled in this study. The prevalence of overweight or obesity was higher in children with AH than the control group. The size of adenoids is significantly different between AH children with and without OME. For children aged over 5, there are significantly higher counts of white blood cells, neutrophils, and monocytes in the AH children with OME than those without OME. More individuals represent to be atopic in children with OME than those without OME. The obstruction of the Eustachian tube is the most important factor of OME in AH children. It seems that there is no apparent correlation between OME and atopic conditions in AH children. In addition to surgical resection of adenoids, active control of infection and inflammation are also important to prevent OME for AH children aged over 5.

Evaluation of Temporal Bone Infections - Comparing Sensitivity of Multiplex Assay to Standard Bacterial Culture

Background: The multiplex assay is a nucleus acid/base assay that can detect a wide array of distinct nucleic acid sequences from different pathogens. This study hopes to show the necessity and utility of this technology in detecting pathogens that cause middle ear infections. Methods: This observational study was conducted from May 2021-July 2022 to assess the sensitivity of a multiplex assay in a microfluidics pouch in the detection of bacterial and viral pathogens in middle ear fluids. Standard bacterial culture was used as a control. Middle ear fluid was obtained from 98 pediatric patients undergoing tympanostomy to treat otitis media. The BioFire PNA panel was used, which detects bacterial, viral, drug resistance, and atypical bacterial nucleic acid targets. Patient demographics, past medical history, and otitis media risk factors were also recorded.&#x0D; Results: A total of 107 ear samples were assessed from 98 patients. The average age of study subjects was 3.53 ± 2.99 years. The population of this study was 61.22% male, 75.51% Caucasian, 22.44% African American, and 2.04% Other, 88.78% Non-Hispanic, 10.2% Hispanic, and 1.02% Unknown. We found that Haemophilus influenzae was she most common pathogen detected (multiplex; culture) - (34.58%; 14.02%), followed by Moraxella catarrhalis (10.28%; 4.67%), Streptococcus pneumoniae (6.54%; 2.80%), Staphylococcus aureus (1.5%; 5.61%), and Proteus spp. (.94%; 0%). All bacteria, except Staphylococcus aureus were identified in more ear specimens by multiplex testing than bacterial culture.&#x0D; Conclusion: Our study demonstrates that multiplex testing is more sensitive than culture in identification of pathogens in middle ear fluid from patients undergoing tympanostomy for treatment of otitis media. The increased sensitivity for bacterial identification and simultaneous detection of viral targets in a very limited patient specimen make the multiplex assay a novel diagnostic tool which may be useful in the management of patients with otitis media in the future.

Factors affecting the occurrence of otitis media with effusion in preschool and elementary school children: a comparative cross-sectional study

ObjectiveIdentify the risk factors for otitis media with effusion (OME), especially laryngopharyngeal reflux (LPR), adenoid hypertrophy and allergic rhinitis, that could be used to develop prevention strategies in children.DesignA comparative...

Patients Requiring Gastrostomy Tube Insertion After Total Laryngectomy Have a Higher Incidence of Otitis Media.

Background and ObjectivesSome reports propose an increased risk of otitis media and hearing impairment after total laryngectomy. However, the incidence of otitis media following laryngectomy and the mechanism remain unclear. This study aimed to identify the incidence and risk factors of otitis media after total laryngectomy.Subjects and MethodsThis retrospective cohort study assessed 77 patients who underwent total laryngectomy from 2010 to 2020 in a tertiary referral center. Serial imaging studies (computed tomography [CT], magnetic resonance imaging, and positron emission tomography-CT) were used to assess otitis media.ResultsThe study enrolled 58 patients (mean age, 67.0±7.7 years; male, 56 [96.6%]); nine (15.5%) underwent a gastrostomy tube (four preoperatively and five postoperatively). Otitis media was confirmed in seven (12.1%) patients. Gastrostomy tube insertion was the only significant risk factor for otitis media (p=0.012). Of the nine patients who underwent gastrostomy tube insertion, four developed otitis media; all four had the procedure after laryngectomy.ConclusionsThis study found an increased incidence of otitis media after total laryngectomy. Swallowing difficulties likely contribute to otitis media as it occurred more frequently in patients requiring postoperative gastrostomy tube insertion.

Prevalence and risk factors of Otitis Media with effusion among preschool children in Arar city, Saudi Arabia

Prevalence and risk factors of Otitis Media with effusion among preschool children in Arar city, Saudi Arabia

Risk Factors for Otitis Media in Children Referred to Abuzar Hospital in Ahvaz: A Case-Control Study.

IntroductionOtitis media is one of the most common causes of infection in preschool children. The most damaging complication of otitis media is temporary or permanent hearing loss. This study aimed to determine the important risk factors for otitis media.MethodsIn this case-control study, 625 children aged six months to seven years were examined from winter to spring 2020, and 53 children with otitis media were allocated to the case group and the same number to the control group. The chi-square test was used to identify the risk factors affecting otitis media, and the risk factors were compared between the case and control groups. Logistic regression was used to investigate the relationship between the incidence of otitis media and risk factors.ResultsBivariate analysis revealed the following primary risk factors for otitis media: using pacifiers or bottle feeding, working mother, seasonal rhinitis, allergic rhinitis, tonsillopharyngitis, rhinorrhea, and adenoid hypertrophy (P<0.05). In logistic regression analysis, using pacifiers or bottle feeding (odds ratio [OR]=0.156, P=0.000), working mother (OR=0.226, P=0.000), seasonal rhinitis (OR=0.175, P=0.000), allergic rhinitis (OR=5.20, P=0.000) and adenoid hypertrophy (OR=1.57, P=0.000) were identified as the most important risk factors.ConclusionAdenoid hypertrophy and allergic rhinitis increased the risk of otitis media more than the other risk factors. Therefore, pediatricians should increase their awareness of the existence of these risk factors in a patient, and take the appropriate diagnostic steps and implement therapeutic care to prevent language and speech complications.

Follow up of a birth cohort to identify prevalence and risk factors for otitis media among Indian children in the eighth year of life

BackgroundOtitis media, a disease highly prevalent among children worldwide, manifests clinically in both acute and chronic forms. The manner and time at which chronicity develops among Indian children is unknown. AimTo study the prevalence, manifestations and risk factors for otitis media in a birth cohort aged 8 years. MethodsA birth cohort of 107 babies was followed up at 8 years of age and ENT evaluation with nasopharyngeal swabbing for detecting Streptococcus pneumoniae and Hemophilus influenzae was performed. ResultsThe overall prevalence of otitis media was 14%, almost half the prevalence in the first 2 years of life. Eight children (7.5%) with congested, bulging eardrums and no systemic symptoms had asymptomatic acute otitis media. Another five (4.7%) children had otitis media with effusion and 2 (1.9%) had chronic suppurative otitis media. Although 10/15 (66.7%) children with otitis media had positive swabs at 8 years age, only 2 were pneumococcal vaccine (PCV-13) serotypes. Risk factor analysis showed that passive smoking was the only significant parameter associated with otitis media (p = 0.029).Nasopharyngeal swabbing showed that 51/105 (48.6%) children had positive swabs for S. pneumoniae and 5/105 (4.8%) for S.pneumoniae with non-type b H. influenzae. The ten most commonly encountered pneumococcal serotypes were 6A,4,8,16F,33B,35A,35B, 18C, 19F and 23B which together comprised 29 of the 56 (51.8%) isolates. PCV-13 serotypes formed 19/56 (33.9%) to 21/56 (37.5%) of all pneumococcal isolates. Of 6 children who had received PCV-13, 4 tested positive for S. pneumoniae at 8 years of age too. However, none were vaccine serotypes. Four of those with otitis media who had positive swabs had received no immunisation at all and 3 of them had vaccine serotypes, viz. 4, 6A and 18C respectively. ConclusionIndian children continue to have a high prevalence of otitis media at 8 years age. More than 1/3 of nasopharyngeal isolates at this age are vaccine serotypes. Passive smoking is an important risk factor for childhood otitis media and may contribute to the development of chronicity of the disease.

Long-Term Otitis Media Outcomes in Infants With Early Tympanostomy Tubes.

To review the otologic outcomes of infants who failed the newborn hearing screen (NBHS) and received early tympanostomy tubes for otitis media with effusion (OME). Retrospective case series. Tertiary care pediatric hospital. Consecutive patients (2007-2018) who failed an NBHS and required tympanostomy tubes before 6 months of age were included. Variables including hearing loss and otitis media risk factors, episodes of acute otitis media (AOM), number of subsequent tympanostomy tubes, and posttympanostomy tube audiogram results were recorded. The cohort included 171 patients. Median age at referral to otolaryngology was 2.7 months. Sensorineural hearing loss (SNHL) was subsequently identified in 22 (12.9%) of infants after resolution of the effusion. The peak incidence of AOM was during the second year of life (1-1.9 years), with a median of 1 episode. Ninety-five patients (55.6%) had replacement of tubes, 41 of 171 (24.0%) had 2 or more additional sets of tubes, and long-term tubes were eventually placed in 8 of 95 (8.4%) patients. Craniofacial anomalies were identified in 43.3% of patients. Tube replacement (hazard ratio, 3.00; 95% CI, 1.95-4.63; P < .01, log-rank) and AOM (β, 1.04; 95% CI, 0.43-1.65; P = .04, ordered logistic regression) were more common, and SNHL less common (odds ratio, 0.17; 95% CI, 0.031-0.61; P < .01, logistic regression), in children with craniofacial anomalies. OME is a common cause of failed NBHS. A notable proportion was subsequently found to have SNHL, reiterating the need for postoperative hearing assessments. Infants meeting indication for early tympanostomy tubes for resolution of OME have a high incidence of recurrent AOM and require subsequent tubes.

Prevalence of allergic rhinitis in children with otitis media with effusion.

Introduction.The prevalence of allergic rhinitis in children with persistent otitis media with effusion in different countries varies between 82% to 93%. Many risk factors of otitis media with effusion has been studied and proven. However, its association with allergic rhinitis remains controversial. Objective. The main objective of this study is to determine the prevalence of allergic rhinitis in children with persistent otitis media with effusion. This study is also aimed to identify the risk factors of otitis media with effusion, common allergens associated with allergic rhinitis and determine the hearing threshold of children with otitis media with effusion. Methods.A hundred and thirty children were recruited. History taking, physical examination and hearing assessment were done in the first visit. Those with allergic rhinitis underwent skin prick test and treated with intranasal corticosteroid and antihistamine. A second examination and hearing assessment were then repeated after 3 months. Results.The prevalence of allergic rhinitis in children with persistent otitis media with effusion in this study was noted to be 80.3%. Among these children, dust mites appeared to be the most common allergen (87.7%). Another risk factor appeared to be families with more than 4 members per-household (96%). It is noted that that otitis media with effusion caused a hearing loss up to 33 dB. However, there was a statistically significant improvement of the hearing threshold during second visit after commencement of allergy treatment. It was also noted that the hearing threshold in allergic rhinitis group was significantly impaired compared to the non-allergic rhinitis group. Conclusions.Allergic rhinitis and larger family household appeared to be common risk factors in children with persistent otitis media with effusion. There is significant hearing loss noted in children suffering from otitis media with effusion and allergic rhinitis. The hearing threshold improved remarkably with medical therapy. This study hence clarifies the controversy on the association between allergic rhinitis and otitis media with effusion.

Asian Sand Dust Particles Increased Pneumococcal Biofilm Formation in vitro and Colonization in Human Middle Ear Epithelial Cells and Rat Middle Ear Mucosa.

IntroductionAir pollutants such as Asian sand dust (ASD) and Streptococcus pneumoniae are risk factors for otitis media (OM). In this study, we evaluate the role of ASD in pneumococcal in vitro biofilm growth and colonization on human middle ear epithelium cells (HMEECs) and rat middle ear using the rat OM model.MethodsS. pneumoniae D39 in vitro biofilm growth in the presence of ASD (50–300 μg/ml) was evaluated in metal ion-free BHI medium using CV-microplate assay, colony-forming unit (cfu) counts, resazurin staining, scanning electron microscopy (SEM), and confocal microscopy (CF). Biofilm gene expression analysis was performed using real-time RT-PCR. The effects of ASD or S. pneumoniae individually or on co-treatment on HMEECs were evaluated by detecting HMEEC viability, apoptosis, and reactive oxygen species (ROS) production. In vivo colonization of S. pneumoniae in the presence of ASD was evaluated using the rat OM model, and RNA-Seq was used to evaluate the alterations in gene expression in rat middle ear mucosa.ResultsS. pneumoniae biofilm growth was significantly (P < 0.05) elevated in the presence of ASD. SEM and CF analysis revealed thick and organized pneumococcal biofilms in the presence of ASD (300 μg/ml). However, in the absence of ASD, bacteria were unable to form organized biofilms, the cell size was smaller than normal, and long chain-like structures were formed. Biofilms grown in the presence of ASD showed elevated expression levels of genes involved in biofilm formation (luxS), competence (comA, comB, ciaR), and toxin production (lytA and ply). Prior exposure of HMEECs to ASD, followed by treatment for pneumococci, significantly (P < 0.05) decreased cell viability and increased apoptosis, and ROS production. In vivo experiment results showed significantly (P < 0.05) more than 65% increased bacteria colonization in rat middle ear mucosa in the presence of ASD. The apoptosis, cell death, DNA repair, inflammation and immune response were differentially regulated in three treatments; however, number of genes expressed in co-treatments was higher than single treatment. In co-treatment, antimicrobial protein/peptide-related genes (S100A family, Np4, DEFB family, and RATNP-3B) and OM-related genes (CYLD, SMAD, FBXO11, and CD14) were down regulated, and inflammatory cytokines and interleukins, such as IL1β, and TNF-related gene expression were elevated.ConclusionASD presence increased the generation of pneumococcal biofilms and colonization.

The social determinants of otitis media in Aboriginal children in Australia: are we addressing the primary causes? A systematic content review

BackgroundAboriginal and Torres Strait Islander children experience some of the highest rates of otitis media in the world. Key risk factors for otitis media in Aboriginal children in Australia are largely social and environmental factors such as overcrowded housing, poverty and limited access to services. Despite this, little is known about how to address these risk factors. A scoping content review was performed to determine the relationship between social determinants of health and otitis media in Aboriginal and Torres Strait Islander children as described by peer-reviewed and grey literature.MethodSearch terms were established for location, population and health condition. The search terms were used to conduct a literature search using six health research databases. Following the exclusion process, articles were scoped, analysed and categorised using scoping parameters and a social determinants of health framework.ResultsHousing-related issues were the most frequently reported determinants for otitis media (56%). Two articles (4%) directly investigated the impact of social determinants of health on rates of otitis media within Aboriginal and Torres Strait Islander children. The majority of the literature (68%) highlights social determinants as playing a key role in the high rates of otitis media seen in Aboriginal populations in Australia. There were no intervention studies targeting social determinants as a means to reduce otitis media rates among Aboriginal and Torres Strait Islander children.ConclusionsThis review identifies a disconnect between otitis media drivers and the focus of public health interventions within Aboriginal and Torres Strait Islander populations. Despite consensus that social determinants play a key role in the high rates of otitis media in Aboriginal and Torres Strait Islander children, the majority of intervention studies within the literature are focussed on biomedical approaches such as research on vaccines and antibiotics. This review highlights the need for otitis media intervention studies to shift away from a purely biomedical model and toward investigating the underlying social determinants of health. By shifting interventions upstream, otitis media rates may decrease within Aboriginal and Torres Strait Islander children, as focus is shifted away from a treatment-focussed model and toward a more preventative model.

Risk factors for otitis media with effusion in children with adenoid hypertrophy.

SUMMARYThe aim of this study was to determine the most important risk factors in the development of otitis media with effusion (OME) in children with adenoid hypertrophy. A total of 539 patients undergoing surgery for adenoid hypertrophy (AH Group) (n = 429) or adenoid hypertrophy and otitis media with effusion (AH + OME Group) (n = 110) between February 2012 and February 2018 constituted the study group. Data were obtained on neonatal history (breastfeeding, bottle feeding), past health and medical history (presence of atopy or allergic rhinitis, snoring at night, cough, tonsillitis in the past 12 months), environmental factors (presence of pets, attending to daycare centers, district of school), family history (passive smoking at home, number of siblings, family size, parental education), and family income. The groups did not differ from each other for age (p = 0.684) and gender (p = 0.728). Our data support the presence of atopy or allergic rhinitis (p < 0.001), frequent (> 5) tonsillitis (p < 0.001), attending to daycare centers (p < 0.001), exposure to smoke (p < 0.001), having 3 or more siblings (p < 0.001), and 4 or more people in the household (p < 0.001) as the main risk factors for OME. Comprehensive knowledge of modifiable risk factors found in this study could help to minimise the complications of OME in children.

Cross-sectional prevalence and risk factors for otitis media and hearing loss in Australian children aged 5 to 7 years: a prospective cohort study

Cross-sectional prevalence and risk factors for otitis media and hearing loss in Australian children aged 5 to 7 years: a prospective cohort study