The "Otitis-Prone" Condition

Howie, Virgil M.; Ploussard, John H.; Sloyer, John L.

doi:10.1001/archpedi.1975.02120430016006

Cited by 104 publications

(78 citation statements)

References 9 publications

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“…Thus, although this survey could not outline cause and effect in an ideal fashion, the results strongly indicated that early age at first AOM episode was an important risk factor for rAOM and that early first AOM episode occurred frequently among children in Nuuk and Sisimiut compared with fmdings in other studies from the Western world (Howie et al 1975, Vinther et al 1979, Ingvarsson et al 1982, Harsten et al 1989, Kvaerner et al 1997b) but in accordance with reports from Alaska (Reed et al 1967, Kaplan et al 1973. Furthermore, familial and ethnical predisposition for AOM, rAOM, and/or COM seems to exist and may be ascribed to both genetical (intrinsic) and environmental (extrinsic) influence.…”

Section: Discussionsupporting

confidence: 62%

“…It has been indicated that early and massive nasopharyngeal colonization with potentially pathogenic bacteria may p1ay a role in the pathogenesis of OM especially in high risk populations (Leach et al 1994, Homøe et al 1996. Risk factors in studies from other parts of the world include race, male gender, cleft palate, young age at first AOM, episode, siblings in the household with URTI, parental history of OM, attendance in large size daycare centers, exposure to passive smoking, lack of breast feeding, feeding position, atopy, prematurity, use of comforter, poor housing standard, and social poverty (i.e., poor living conditions) (Christensen 1956, Howie et al 1975, Strangert 1977, Ingvarsson et al 1982b, Saarinen 1982, Vinther et al 1982, Ståhiberg et al 1986, Fleming et al 1987, Kero and Piekkala 1987, Shapiro 1988, Harsten et al 1989, Teele et al 1989, Alho et al 1990, Froom and Culpepper 1991, Duncan et al 1993, Bastos 1994, Aniansson et al 1994, Ey et al 1995, Marx et al 1995, Sorri et al 1996, Uhari et al 1996, Kvaerner et al 1997aand b, Stenstrom and Ingvarsson 1997a, Daly et al 1999. However, results are conflicting for several of these risk factors, and most have only slightly been found to increase the risk for AOM.…”

Section: Aimsmentioning

confidence: 99%

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Otitis Media in Greenland: studies on historical, epidemiological, microbiological, and immunological aspects

Homøe¹

2001

International Journal of Circumpolar Health

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Section: Discussionsupporting

confidence: 62%

Section: Aimsmentioning

confidence: 99%

Otitis Media in Greenland: studies on historical, epidemiological, microbiological, and immunological aspects

Homøe¹

2001

International Journal of Circumpolar Health

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“…Lower immunoglobulin levels in otitis-prone children suggest a generalized decreased antibody response in otitis-prone children. Based on the clinical observation that some children experience recurrent episodes of acute otitis media (AOM), the term "otitis-prone" was introduced by Howie (1). In general, the otitis-prone condition is defined as three or more episodes of AOM in 6 mo or four or more episodes in 12 mo; up to 5% of all children comply with this definition (2,3).…”

mentioning

confidence: 99%

Immunoglobulins in Otitis-Prone Children

et al. 2004

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Defective or immature antibody responses to pathogens in children may explain the increased susceptibility to acute otitis media (AOM) in otitis-prone children. In literature, data on immunology have been based on studies of small groups of severely otitis-prone children and have not been consistent. Humoral immune status was assessed in 365 children, 1-7 years old, with two or more documented episodes of AOM in the previous year. Children with 4 or more episodes in the preceding year were defined as otitis-prone. Serum immunoglobulin levels were determined by radial immunodiffusion. Immunoglobulin levels of otitis-prone children were compared with those of children who had experienced 2-3 AOM episodes per year. Children with recurrent episodes of AOM were found to have normal or increased serum IgA, IgM, IgG, and IgG1 levels compared with normal values for age, whereas the serum IgG2 levels were mostly in the lower normal range. Twenty-two percent of all children showed IgG2 levels lower than 2 SD below the age-specific mean. Interestingly, the otitis-prone group of children showed significantly lower median and mean levels for all immunoglobulins compared with those children with only 2-3 previous AOM episodes. Lower immunoglobulin levels in otitis-prone children suggest a generalized decreased antibody response in otitis-prone children. Based on the clinical observation that some children experience recurrent episodes of acute otitis media (AOM), the term "otitis-prone" was introduced by Howie (1). In general, the otitis-prone condition is defined as three or more episodes of AOM in 6 mo or four or more episodes in 12 mo; up to 5% of all children comply with this definition (2, 3).With respect to immunoglobulin serum levels, both normal as well as stimulated serum IgA, IgM, IgG, and IgG1 levels have been reported in otitis-prone children aged 2 mo or older (4, 5). Freijd et al. and Sørensen et al. reported lower levels of IgG2 in children with recurrent AOM compared with agematched controls (5, 6), but others did not confirm these observations (4, 7).With respect to antibody activity against the two main bacterial pathogens in AOM Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHI), subnormal or absent antibody responses have been reported in otitis-prone children (8 -11), as well as decreased antibody responses upon immunization with Hib conjugate and rubella vaccine (12, 13).These findings may suggest decreased antibody responses upon both T cell-dependent as well as T cell independent antigens in otitis-prone children (14). Hitherto, immunologic evaluations have been performed only in small groups of otitis-prone children. The need to obtain more substantial data led us to analyze immunoglobulins in a large group of 365 children with varying susceptibility to acute otitis media. METHODSThis study was conducted in a general hospital (Spaarne Hospital Haarlem) and a tertiary care hospital (University Medical Center Utrecht), the Netherlands. The Medical Ethics Committees of both participa...

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“…Due to this reason, inspite of the fact that spontaneous resolution of OME may occur in some cases with time, it is better to do an early surgical intervention to prevent unwanted sequelae. 15 It would benefit the child if the OME were identified in the early stages itself. Development of OME hampers language learning in the early years of life.…”

Section: Discussionmentioning

confidence: 99%

A study on the effect of adenoidectomy with tonsillectomy in otitis media with effusion in children

2017

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INTRODUCTIONDisease of adenoids and tonsils are among the most common problems in children. Recurrent upper respiratory tract infections (URTI) affect the adenoids resulting in hyperplasia, nasal obstruction, snoring, mouth breathing and hyponasal speech.1 The effect of both obstruction and infection from tonsil and adenoid are seen to cause major ill effect nose and paranasal sinus, eustachian tube and middle ear cleft. 2 It has been postulated that the enlargement of adenoids or repeated infections of adenoids result in Otitis media with effusion (OME).2 Synonyms of OME include glue ear, serous otitis media, secretory otitis media and chronic ABSTRACT Background: The aural symptoms attributed to adenoid hypertrophy are Eustachian tube block (ET) and otitis media with effusion (OME). It is thought that adenoid hypertrophy causes a block in air flow through the ET, thus creating a negative pressure in the middle ear leading to effusion which acts as a focus of infection. The role of hypertrophied tonsils in the aetiology of OME is controversial. Adenoid and tonsillar hypertrophy and associated inflammation continue to be a major problem in paediatric age group despite the advances in medicine. Otitis media with effusion is a treatable cause of deafness which may hamper the learning ability of a child. This study was undertaken to study the effect of adenoidectomy with tonsillectomy on established otitis media with effusion in children. Methods: 35 children presenting to the department of ENT, Government Medical College, Thrissur, Kerala, India over one and a half years with features suggestive of secretory otitis media, tonsillar and adenoid hypertrophy who underwent adenoidectomy with tonsillectomy in Government Medical College, Thrissur, Kerala, India were included in the study. A predesigned questionnaire was prepared which included details on clinical symptoms, relevant investigations and preoperative and postoperative evaluation of hearing after 6 weeks and 3 months. Data collected was analyzed using paired t-test and chi square test to determine the improvement in hearing after 6 weeks and 3 months following surgery. Results: Out of the 35 children included in the study, it was seen that 56% of cases, after 6 weeks showed complete resolution of OME which improved to 67% after 3 months. This was assessed by PTA and tympanometry. 33% showed partial improvement with Type C curve in tympanometry and improvement in PTA values. Conclusions: All cases of OME associated with adenoid and tonsillar hypertrophy responded to our treatment with 67% showing complete cure of the condition. It can be assumed that, in the 33% partial responders there may be other factors like allergy, anatomical deformities, immunological which prevented the complete resolution of symptoms in OME.

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The "Otitis-Prone" Condition

Cited by 104 publications

References 9 publications

Otitis Media in Greenland: studies on historical, epidemiological, microbiological, and immunological aspects

Otitis Media in Greenland: studies on historical, epidemiological, microbiological, and immunological aspects

Immunoglobulins in Otitis-Prone Children

A study on the effect of adenoidectomy with tonsillectomy in otitis media with effusion in children

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