The Association Between ENT Diseases and Obesity in Pediatric Population: A Systemic Review of Current Knowledge

Abstract

Obesity in pediatric population is an important global problem. The prevalence of obesity in children is dramatically rising. According to World Health Organization, about 41 million children under the age of 5 years are obese or overweight worldwide. Overweight and obesity are well-known risk factors for a number of health disorders. Diseases commonly observed in this group of patients are metabolic disorders, type 2 diabetes mellitus, cardiovascular diseases, fatty liver disease, musculoskeletal problems, and many others. The main aim of this study was to present the current knowledge of the association between childhood obesity and common otorhinolaryngological disorders. It is suggested that obese children are more prone to suffer from otorhinolaryngological illnesses than the lean ones. Obesity may predispose to otorhinolaryngological diseases in various ways. It strongly interferes with the immune system (increases serum levels of interleukin 6, tumor necrosis factor, C-reactive protein, and leptin and reduces adiponectin concentration) affecting organs of the upper respiratory tract. Additionally, obesity induces mechanical disorders in the upper airways. According to our review, obesity predisposes to otitis media with effusion, acute otitis media, recurrent otitis media, obstructive sleep apnea, sensorineural hearing loss, adenotonsillar hypertrophy, and post-/perioperative complications after adenotonsillectomy. Obesity in children significantly correlates with both obstructive sleep apnea (OSA) and asthma and constitutes a significant component of ''OSA, obesity, asthma'' triad.

Considerations in Surgical Management of Pediatric Obstructive Sleep Apnea: Tonsillectomy and Beyond

“…Obstructive sleep apnea in children has a reported incidence of up to 5.7% in childhood [16,18,19] and in obese children, the prevalence rises to 60% [20]. This is a spectrum of disease ranging from primary snoring, upper airway resistance syndrome, to OSA.…”

“…Recognized risk factors for persistent OSA post-tonsillectomy include children with asthma, allergic rhinitis, age > 7 years, black ethnicity, obesity, syndromic features, or severe pre-operative OSA [14,18,20,28,59]. The severity of the pre-operative OSA is a clinical predictor for residual OSA, with severe OSA defined as an AHI > 4.7 [18,28].…”

“…The severity of the pre-operative OSA is a clinical predictor for residual OSA, with severe OSA defined as an AHI > 4.7 [18,28]. Obesity can also increase the risk of residual post-operative OSA by 3.7-fold [20].…”

Severe paediatric obesity and sleep: A mutual interactive relationship!

“…Obstructive sleep apnea is a common co‐morbidity with obesity and asthma. A bidirectional relationship between OSA and asthma has been established by Chng, Goh, Wang, Tan, and Ong (2004), and Krajewska et al (2019) propose the “OSA, Asthma, and Obesity” triad to further describe these relationships. Obesity is often found in coincidence with asthma, and an “obese asthma” phenotype has been proposed (Novosad, Khan, Wolfe, & Khan, 2013).…”

Association of Diet Patterns and Post‐Operative Tympanostomy Tube Otorrhea: A Pilot Study

“…While there is some understanding of patient factors contributing to otitis media (OM), this is less defined for TTO. Predisposing factors for OM described in the literature include premature birth, family history of OM, smoke exposure, daycare, formula‐fed infant, craniofacial abnormalities, obesity, diet, and possibly food/environmental allergies 6–9 . Research on factors that may increase the risk of TTO has focused more on ear tube biofilms, water exposure, and the bacteriology of middle ear fluid, and less on individual patient factors 10,11 .…”