Otitis Media with Effusion in Primary Schools in Princes' Islands, Istanbul: Prevalence and Risk Factors

Abstract

The prevalence of otitis media with effusion (OME) and environmental risk factors were investigated in 423 children aged 7 -12 years at three primary schools in Princes' Islands, Istanbul, Turkey. An ear, nose and throat examination, including tympanometry, was performed in April (end of the school year) and the families completed a questionnaire about potential risk factors. Type B or C2 tympanograms were taken as indicating OME. The overall prevalence of OME was 16%. OME was significantly associated with numbers of episodes of upper respiratory tract infections (URTI) and acute otitis media (AOM) during the previous year, class size and snoring, but not with allergic symptoms, kindergarten years, breastfeeding duration, parental smoking, domestic animals at home, numbers of siblings and family members, type of home heating, parents' educational level or monthly income. Four or more URTIs and two or more AOM episodes in a year, snoring and class size larger than 20 were risk factors for OME.

Risk Factors for Refractory and Delayed De Novo Otitis Media Requiring Pressure Equalization Tube Insertion

“…Within our patient population, this likely represents the fact that these children have been tied in to the healthcare network and those younger patients with history of recurrent tonsillitis and/or snoring would be considered as candidates for tonsillectomy and adenoidectomy in conjunction with any tympanostomy tube insertion procedures. The close relationship between snoring and otitis media has been confirmed across numerous studies [4][5][6][7]11]. While it is important to note that this risk decreased significantly between the 6-7 year-olds and 8-12 year-olds, the overall rate of snoring within our older cohort is still relatively high (47.6%).…”

“…Similar to gender, the literature has shown mixed results. Some studies have failed to indicate any association with parental smoking and otitis media [6,11,12,15], while others demonstrate a clear relationship [4,5,8]. There was a trend toward increased parental smoking within our older patient cohort compared to our younger cohort (OR 1.61, p = 0.09).…”

“…Perhaps more interesting is examining the rate of parental smoking exposure. Compiling rates from the previous literature, approximately 14.2% of those with OM had exposure to passive smoke [4,[6][7][8]11,12]. In contrast, our patients who have undergone PET insertion for COM/ROM had exposure rates of 22.2-31.4%.…”

“…Upper respiratory tract infections (URTIs) have been universally identified as a significant prognostic factor for COM/ROM [5][6][7][8]. Studies have shown that the opening and closing function of the eustachian tube (ET) [13], as well as the extent of inflammation on ET mucosa [14] are affected by URTIs.…”

“…An extensive literature review was conducted to identify risk factors for COM/ROM with a particular focus on those studies in school-age children [3][4][5][6][7][8][9][10][11][12]. Based on this information, a data collection form with pertinent factors relating to demographics, social environment, and patient history was developed.…”