Hostname: page-component-6766d58669-h8lrw Total loading time: 0 Render date: 2026-05-19T02:37:39.079Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors associated with the development of paediatric chronic otitis media by age nine: a prospective longitudinal cohort study of 6560 children

Published online by Cambridge University Press:  19 November 2020

P J Clamp ,
K De-Loyde ,
A R Maw ,
S Gregory ,
J Golding  and
A Hall
P J Clamp*
Affiliation:
Department of ENT, University Hospitals Bristol NHS Foundation Trust, Bristol, UK School of Social and Community Medicine, University of Bristol, UK
K De-Loyde
Affiliation:
School of Social and Community Medicine, University of Bristol, UK
A R Maw
Affiliation:
School of Social and Community Medicine, University of Bristol, UK
S Gregory
Affiliation:
School of Social and Community Medicine, University of Bristol, UK
J Golding
Affiliation:
School of Social and Community Medicine, University of Bristol, UK
A Hall
Affiliation:
Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK Life and Health Sciences, Aston University, Birmingham, UK
*
Author for correspondence: Mr Philip J Clamp, Department of ENT, St. Michael Hospital, University Hospitals Bristol, Southwell Street, Bristol BS2 8EG, UK E-mail: philip.clamp@uhbristol.nhs.uk
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Otitis MediaCholesteatomaTympanic Membrane PerforationPediatricsRisk FactorsCohort StudiesHearing LossOtological Surgical ProceduresMiddle Ear VentilationSnoringTonsillectomyAdenoidectomy

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 11 , November 2020 , pp. 998 - 1009
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Mr P J Clamp takes responsibility for the integrity of the content of the paper

Presented at British Academic Conference in Otolaryngology International, 4–6 July 2018, Manchester, UK.

References

Teele, DW, Klein, JO, Rosner, B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989;160:83–94CrossRefGoogle ScholarPubMed
Bluestone, CD. Epidemiology and pathogenesis of chronic suppurative otitis media: implications for prevention and treatment. Int J Pediatr Otorhinolaryngol 1998;42:207–23CrossRefGoogle ScholarPubMed
Monasta, L, Ronfani, L, Marchetti, F, Montico, M, Vecchi Brumatti, L, Bavcar, A et al. Burden of disease caused by otitis media: systematic review and global estimates. PLoS One 2012;7:e36226CrossRefGoogle ScholarPubMed
Acuin, J, World Health Organisation. Chronic Suppurative Otitis Media: Burden of Illness and Management Options. Geneva: World Health Organisation, 2004Google Scholar
Nunez, DA, Browning, GG. Risks of developing an otogenic intracranial abscess. J Laryngol Otol 1990;104:468–72CrossRefGoogle ScholarPubMed
Browning, GG, Gatehouse, S. The prevalence of middle ear disease in the adult British population. Clin Otolaryngol Allied Sci 1992;17:317–21CrossRefGoogle ScholarPubMed
Elemraid, MA, Mackenzie, IJ, Fraser, WD, Harper, G, Faragher, B, Atef, Z et al. A case-control study of nutritional factors associated with chronic suppurative otitis media in Yemeni children. Eur J Clin Nutr 2011;65:895–902CrossRefGoogle ScholarPubMed
Fliss, DM, Shoham, I, Leiberman, A, Dagan, R. Chronic suppurative otitis media without cholesteatoma in children in southern Israel: incidence and risk factors. Pediatr Infect Dis J 1991;10:895–9Google ScholarPubMed
Koch, A, Homoe, P, Pipper, C, Hjuler, T, Melbye, M. Chronic suppurative otitis media in a birth cohort of children in Greenland: population-based study of incidence and risk factors. Pediatr Infect Dis J 2011;30:25–9CrossRefGoogle Scholar
Lasisi, AO, Olaniyan, FA, Muibi, SA, Azeez, IA, Abdulwasiu, KG, Lasisi, TJ et al. Clinical and demographic risk factors associated with chronic suppurative otitis media. Int J Pediatr Otorhinolaryngol 2007;71:1549–54CrossRefGoogle ScholarPubMed
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:e0125905CrossRefGoogle ScholarPubMed
Santos-Cortez, RL, Reyes-Quintos, MR, Tantoco, ML, Abbe, I, Llanes, EG, Ajami, NJ et al. Genetic and environmental determinants of otitis media in an indigenous Filipino population. Otolaryngol Head Neck Surg 2016;155:856–62CrossRefGoogle Scholar
Shaheen, MM, Raquib, A, Ahmad, SM. Prevalence and associated socio-demographic factors of chronic suppurative otitis media among rural primary school children of Bangladesh. Int J Pediatr Otorhinolaryngol 2012;76:1201–4CrossRefGoogle ScholarPubMed
Spilsbury, K, Miller, I, Semmens, JB, Lannigan, FJ. Factors associated with developing cholesteatoma: a study of 45,980 children with middle ear disease. Laryngoscope 2010;120:625–30CrossRefGoogle ScholarPubMed
Wang, J, Chen, B, Xu, M, Wu, J, Wang, T, Zhao, J et al. Etiological factors associated with chronic suppurative otitis media in a population of Han adults in China. Acta Otolaryngol 2016;136:1024–8CrossRefGoogle Scholar
Zakzouk, SM, Hajjaj, MF. Epidemiology of chronic suppurative otitis media among Saudi children—a comparative study of two decades. Int J Pediatr Otorhinolaryngol 2002;62:215–8CrossRefGoogle ScholarPubMed
van der Veen, EL, Schilder, AG, van Heerbeek, N, Verhoeff, M, Zielhuis, GA, Rovers, MM. Predictors of chronic suppurative otitis media in children. Arch Otolaryngol Head Neck Surg 2006;132:1115–8CrossRefGoogle ScholarPubMed
Taipale, A, Pelkonen, T, Taipale, M, Bernardino, L, Peltola, H, Pitkaranta, A. Chronic suppurative otitis media in children of Luanda, Angola. Acta Paediatr 2011;100:e84–8CrossRefGoogle ScholarPubMed
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:e86397CrossRefGoogle ScholarPubMed
Maw, AR, Hall, AJ, Pothier, DD, Gregory, SP, Steer, CD. The prevalence of tympanic membrane and related middle ear pathology in children: a large longitudinal cohort study followed from birth to age ten. Otol Neurotol 2011;32:1256–61CrossRefGoogle ScholarPubMed
Boyd, A, Golding, J, Macleod, J, Lawlor, DA, Fraser, A, Henderson, J et al. Cohort profile: the ‘children of the 90s’—the index offspring of the Avon Longitudinal Study of Parents and Children. Int J Epidemiol 2013;42:111–27CrossRefGoogle ScholarPubMed
Djurhuus, BD, Skytthe, A, Faber, CE, Christensen, K. Cholesteatoma risk in 8,593 orofacial cleft cases and 6,989 siblings: a nationwide study. Laryngoscope 2015;125:1225–9CrossRefGoogle ScholarPubMed
Sheahan, P, Blayney, AW, Sheahan, JN, Earley, MJ. Sequelae of otitis media with effusion among children with cleft lip and/or cleft palate. Clin Otolaryngol Allied Sci 2002;27:494–500CrossRefGoogle ScholarPubMed
Browning, GG, Merchant, SN, Kelly, G, Swan, IRC, Canter, R, Mckerrow, WS. Chronic otitis media. In: Gleeson, M, ed. Scott-Brown's Otorhinolaryngology, Head and Neck Surgery, 7th edn. London: Hodder Arnold, 2008;3395–445CrossRefGoogle Scholar
Roberts, G, Peckitt, C, Northstone, K, Strachan, D, Lack, G, Henderson, J et al. Relationship between aeroallergen and food allergen sensitization in childhood. Clin Exp Allergy 2005;35:933–40CrossRefGoogle ScholarPubMed
Williams, HC, Burney, PG, Hay, RJ, Archer, CB, Shipley, MJ, Hunter, JJ et al. The U.K. Working Party's diagnostic criteria for atopic dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis. Br J Dermatol 1994;131:383–96CrossRefGoogle ScholarPubMed
Williams, HC, Burney, PG, Pembroke, AC, Hay, RJ. The U.K. Working Party's diagnostic criteria for atopic dermatitis. III. Independent hospital validation. Br J Dermatol 1994;131:406–16CrossRefGoogle ScholarPubMed
Williams, HC, Burney, PG, Strachan, D, Hay, RJ. The U.K. Working Party's diagnostic criteria for atopic dermatitis. II. Observer variation of clinical diagnosis and signs of atopic dermatitis. Br J Dermatol 1994;131:397–405CrossRefGoogle ScholarPubMed
Fraser, A, Macdonald-Wallis, C, Tilling, K, Boyd, A, Golding, J, Davey Smith, G et al. Cohort profile: the Avon Longitudinal Study of Parents and Children: ALSPAC mothers cohort. Int J Epidemiol 2013;42:97–110CrossRefGoogle ScholarPubMed
Brockbank, JC. Update on pathophysiology and treatment of childhood obstructive sleep apnea syndrome. Paediatr Respir Rev 2017:21–23Google ScholarPubMed
Chinnadurai, S, Jordan, AK, Sathe, NA, Fonnesbeck, C, McPheeters, ML, Francis, DO. Tonsillectomy for obstructive sleep-disordered breathing: a meta-analysis. Pediatrics 2017;139:e20163491CrossRefGoogle ScholarPubMed
Ehsan, Z, Ishman, SL. Pediatric obstructive sleep apnea. Otolaryngol Clin North Am 2016;49:1449–64CrossRefGoogle ScholarPubMed
Group MRCMOMS. Adjuvant adenoidectomy in persistent bilateral otitis media with effusion: hearing and revision surgery outcomes through 2 years in the TARGET randomised trial. Clin Otolaryngol 2012;37:107–16CrossRefGoogle Scholar
Persaud, R, Hajioff, D, Trinidade, A, Khemani, S, Bhattacharyya, MN, Papadimitriou, N et al. Evidence-based review of aetiopathogenic theories of congenital and acquired cholesteatoma. J Laryngol Otol 2007;121:1013–9CrossRefGoogle ScholarPubMed
Hamed, MA, Nakata, S, Sayed, RH, Ueda, H, Badawy, BS, Nishimura, Y et al. Pathogenesis and bone resorption in acquired cholesteatoma: current knowledge and future prospectives. Clin Exp Otorhinolaryngol 2016;9:298–308CrossRefGoogle ScholarPubMed
Jackler, RK, Santa Maria, PL, Varsak, YK, Nguyen, A, Blevins, NH. A new theory on the pathogenesis of acquired cholesteatoma: mucosal traction. Laryngoscope 2015;125(suppl 4):1–14CrossRefGoogle ScholarPubMed
Jennings, BA, Prinsley, P, Philpott, C, Willis, G, Bhutta, MF. The genetics of cholesteatoma. A systematic review using narrative synthesis. Clin Otolaryngol 2018;43:55–67Google ScholarPubMed
Louw, L. Acquired cholesteatoma pathogenesis: stepwise explanations. J Laryngol Otol 2010;124:587–93CrossRefGoogle ScholarPubMed
Olszewska, E, Wagner, M, Bernal-Sprekelsen, M, Ebmeyer, J, Dazert, S, Hildmann, H et al. Etiopathogenesis of cholesteatoma. Eur Arch Otorhinolaryngol 2004;261:6–24CrossRefGoogle ScholarPubMed
Ramakrishnan, Y, Kotecha, A, Bowdler, DA. A review of retraction pockets: past, present and future management. J Laryngol Otol 2007;121:521–5CrossRefGoogle ScholarPubMed
Wells, MD, Michaels, L. Role of retraction pockets in cholesteatoma formation. Clin Otolaryngol Allied Sci 1983;8:39–45CrossRefGoogle ScholarPubMed
Yoon, TH, Schachern, PA, Paparella, MM, Aeppli, DM. Pathology and pathogenesis of tympanic membrane retraction. Am J Otolaryngol 1990;11:10–7CrossRefGoogle ScholarPubMed
Bluestone, CD, Cantekin, EI, Beery, QC, Stool, SE. Function of the Eustachian tube related to surgical management of acquired aural cholesteatoma in children. Laryngoscope 1978;88:1155–64CrossRefGoogle ScholarPubMed
Yuceturk, AV, Unlu, HH, Okumus, M, Yildiz, T, Filiz, U. The evaluation of eustachian tube function in patients with chronic otitis media. Clin Otolaryngol Allied Sci 1997;22:449–52CrossRefGoogle ScholarPubMed
Hassman-Poznanska, E, Kurzyna, A, Trzpis, K, Poznanska, M. The status of the contralateral ear in children with acquired cholesteatoma. Acta Otolaryngol 2012;132:404–8CrossRefGoogle ScholarPubMed
Jadia, S, Mourya, A, Jain, L, Qureshi, S. Pre and post operative status of contralateral ear in unilateral chronic otitis media. Indian J Otolaryngol Head Neck Surg 2016;68:20–4CrossRefGoogle ScholarPubMed
Engel, J, Anteunis, L, Volovics, A, Hendriks, J, Marres, E. Prevalence rates of otitis media with effusion from 0 to 2 years of age: healthy-born versus high-risk-born infants. Int J Pediatr Otorhinolaryngol 1999;47:243–51CrossRefGoogle ScholarPubMed
Engel, JA, Straetemans, M, Zielhuis, GA. Birth characteristics and recurrent otitis media with effusion in young children. Int J Pediatr Otorhinolaryngol 2005;69:533–40CrossRefGoogle ScholarPubMed
Korvel-Hanquist, A, Koch, A, Niclasen, J, Dammeye, J, Lous, J, Olsen, SF et al. Risk factors of early otitis media in the danish national birth cohort. PLoS One 2016;11:e0166465CrossRefGoogle ScholarPubMed
Khalid-Raja, M, Tikka, T, Coulson, C. Cholesteatoma: a disease of the poor (socially deprived)? Eur Arch Otorhinolaryngol 2015;272:2799–805CrossRefGoogle Scholar
Supplementary material: File

Clamp et al. supplementary material

Tables S1-S3

Download Clamp et al. supplementary material(File)
File 70.7 KB