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Ǵм Yeungnam Univ J Med 2018;35(1):70-75


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

Ju Yeon Lee1, Se-Hyung Kim2, Chan Il Song2, Young Ree Kim3, Yoon-Joo Kim4, Jae Hong Choi4
1Department of Pediatrics, Jeju National University Hospital; Departments of 2Otorhinolaryngology,
3Laboratory Medicine, 4Pediatrics, Jeju National University School of Medicine, Jeju, Korea
Corresponding Author: Jae Hong Choi, Department of Pediatrics, Jeju National University School of Medicine, Aran-13gil, Jeju 63241, Korea
Tel: +82-64-717-1476, Fax: +82-64-717-1079
E-mail: jhchoi@jejunu.ac.kr

Received: April 3, 2018, Revised: May 10, 2018 Accepted: May 31, 2018


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.

Key Words: Keywords: Otitis media with effusion; Middle ear ventilation; Risk factors