“…The proposed role of obesity in hearing impairment could be due to decreased plasma adiponectin levels according to animal studies [14,15]. Additionally, the two hypotheses that could help explaining the link between obesity and otitis media occurrence are: first, obesity is known for its underlined low-grade and systemic inflammatory state, which has been shown to impair host immune defense against infections [16]; and second, by causing gastroesophageal reflux, a well-known factor related to otolaryngologic manifestations [17].…”