Yeungnam Univ J Med.  2018 Jun;35(1):70-75. 10.12701/yujm.2018.35.1.70.

Risk factors for persistent otitis media with effusion in children: a case-control study

Affiliations
  • 1Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.
  • 2Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Korea.
  • 3Department of Laboratory Medicine, Jeju National University School of Medicine, Jeju, Korea.
  • 4Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea. jhchoi@jejunu.ac.kr

Abstract

BACKGROUND
Otitis media with effusion (OME) is defined as middle ear effusion without acute signs of infection. OME usually resolves spontaneously; however, persistent OME may require the insertion of a ventilation tube. This study investigated risk factors for persistent OME in children who undergo ventilation tube insertion.
METHODS
Children who were admitted to undergo ventilation tube insertion at Jeju National University Hospital between August 2015 and July 2016 were enrolled as the case group. Healthy children without persistent OME from August 2016 to July 2017 were enrolled as the control group. Baseline characteristics and predisposing factor data were collected using an interview questionnaire. Middle ear fluids were collected from the case group.
RESULTS
A total of 31 patients underwent ventilation tube insertion. The mean age of the case group was 4.53 years, with a male-to-female ratio of 21:10. Twenty-nine (93.5%) children attended a daycare center, and 21 (67.7%) had experience with bottle feeding. Fifteen (48.4%) children in the case group and 3 (9.7%) in the control group first attended a daycare center at < 1 year of age (odds ratio=9.96; 95% confidence interval=2.44-39.70; p=0.001). No bacteria were found in middle ear fluid collected from the 31 operated children. Nasopharyngeal bacterial colonization was found in 13 (41.9%) and 17 (54.8%) children in the case and control groups, respectively.
CONCLUSION
Earlier attendance at a daycare center was the only predisposing factor for ventilation tube insertion in our study. The aseptic nature of middle ear fluids found in children with OME highlights the efficacy of antimicrobial use.

Keyword

Otitis media with effusion; Middle ear ventilation; Risk factors

MeSH Terms

Bacteria
Bottle Feeding
Case-Control Studies*
Causality
Child*
Colon
Ear, Middle
Humans
Middle Ear Ventilation
Otitis Media with Effusion*
Otitis Media*
Otitis*
Risk Factors*
Ventilation

Figure

  • Fig. 1. Odds ratio of patient characteristics who underwent ventilation tube insertion. DCC, daycare center; Hib, Haemophilus influenzae type b; PCV, pneumococcal conjugate vaccine.


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