An epidemiological approach to the etiology of middle ear disease in The Netherlands

Abstract

The etiology of middle ear disease in Nijmegen, The Netherlands was studied on the basis of a data set collected in a prospective epidemiological study on otitis media with effusion (OME) in a cohort of 1439 preschool children. A factor analysis was used to evaluate two hypotheses: (1) that OME, acute otitis media (AOM), common cold and tonsillitis are manifestations of the same pathological entity, and (2) that a group of children can be distinguished who develop these conditions more frequently than average. The results only partly supported these hypotheses. The correlation between OME, AOM, common cold and tonsillitis was lower than expected from a review of the literature. Common cold appeared to be the ubiquitous ENT disease in childhood and, depending on the child's predisposition, could be accompanied by OME, AOM or tonsillitis. The course of middle ear and upper airway disease showed a gradual scale from "healthy" to "ill" with most of the children suffering from these conditions at an average frequency.

Heritability of Recurrent Tonsillitis

“…23 A subsequent recommendation has been to show a conservative attitude to adenotonsillectomy, especially in young age groups. 19 Schilder et al 24 reported a significant correlation between acute tonsillitis and acute otitis media in the same child. The same study 24 claimed that the common cold is the ubiquitous upper airway disease and that accompanying morbidity, such as tonsillitis and otitis media, depends on the predisposition of the child.…”

Epidemiology and Pathogenesis of Otitis Media: Construction of a Phenotype Landscape

“…The majority of children undergoing ventilation tube (grommet) surgery give a clinical history of rAOM or of hearing loss suggestive of COME, but only sometimes a history of both of these symptom domains. Schilder et al [1992] undertook a principal component analysis of upper respiratory tract symptoms in an unselected cohort of 999 children aged 2-4 years, and showed that URTI was correlated to presence of AOM and OME, but that in children with increasingly severe or persistent symptoms, occurrence of OME and AOM became more separated. One study found that 88% of children undergoing surgery for COME had an effusion confirmed at operation, whereas only 26% of those undergoing surgery for rAOM had an effusion [Jardine et al, 1999], suggesting some biological difference in these phenotypes.…”

Recurrent otitis media and tonsillitis: common disease predisposition

“…The phenotypic correlation was 0.42 between otitis media and tonsillitis in these data and is rather high compared to other studies which reported 0.18 [4] and 0.19 [5]. One study [5] was based on Dutch children who were clinically screened every 3 months between their second and fourth birthday.…”

“…The close relationship between otitis media and tonsillitis has been demonstrated in more recent epidemiological studies [3][4][5]. In addition, a prospective study of preschool children [5] suggested that tonsillar infections accompany common colds in some children, while others seem to be predisposed to subsequent middle ear disease.…”

“…The close relationship between otitis media and tonsillitis has been demonstrated in more recent epidemiological studies [3][4][5]. In addition, a prospective study of preschool children [5] suggested that tonsillar infections accompany common colds in some children, while others seem to be predisposed to subsequent middle ear disease. Kvaerner et al reported a moderate but significant association between recurrent otitis media and tonsillitis both in a cross-sectional study of preschool children [4] and a in a retrospective questionnairebased study of Norwegian twins [3].…”