Personalized predictive modeling of otitis media with effusion: a multivariable approach to individualized prognosis, hearing rehabilitation, and follow-up

Abstract

Introduction Otitis media with effusion (OME) is a highly prevalent condition in pediatric patients, affecting up to 55% of children under two years of age. Several factors contribute to its development, including immature Eustachian tube function, allergic factors, and adenoidal obstruction, making treatment optimization challenging yet essential due to the potential consequences of this condition. The primary objective of this study is to analyze the influence of various etiological, clinical, and therapeutic variables on functional auditory outcomes using a binary logistic regression model. Secondarily, the study aims to identify whether these variables are associated with adverse outcomes such as the need for hearing aids or delayed language development. Methods This is a single-center, observational, descriptive, and retrospective cohort study conducted between 2020 and 2023, with a 12-month follow-up period. Functional outcomes, risk of complications, and their timing were analyzed, among other variables. Results A total of 95 patients were included, with a mean age of 3.82 ± 1.94 years, predominantly male (64.21%, n = 61) and with bilateral involvement (85.26%, n = 81). A mean hearing improvement of 9.07 ± 20.07 dB was observed at the end of the follow-up. Multivariable regression analysis revealed that the PTA at 6 months is a significant predictor of long-term auditory outcomes ( p = 0.036), while adenoidectomy acts as a protective factor ( p = 0.042). Chronic otitis media (COM), PTA at 12 months, and persistent OME were associated with a higher risk of requiring hearing aids ( p = 0.036, 0.009, and 0.006, respectively), while the latter two were also linked to a greater risk of delayed language development ( p = 0.030 and 0.011). Conclusions The study identifies that PTA at 12 months, COM, and persistent OME significantly increase the risk of needing hearing aids and speech therapy. Elevated PTA at 6 months is an early predictor of poor prognosis, while adenoidectomy, despite being a protective factor for auditory outcomes, may be associated with earlier complications. Evenmore, this work illustrates how real-world clinical and audiological data can be translated into actionable personalized care pathways, supporting more precise clinical decisions and improving long-term outcomes in children with OME.