The otitis-prone child : studies of a condition with a multifactorial background

Acute otitis media (AOM) is a common complication after episodes of respiratory tract infections in childhood. Some children have recurrent episodes and they are often called otitis-prone. These children are prone not only to middle-ear diseases but also to other infectious diseases. The aims of the present study of otitis-prone children and controls were to describe the overall illness and need for medical care; to study whether heredity, perinatal factors, allergy, and environmental factors influenced the recurrence of AOM; to investigate the Eustachian tube function in extremely otitis-prone children and healthy controls; to evaluate the condition of the middle ear and tympanic membrane in otitis-prone children and controls; and to follow the history of middle-ear disease and sequelae in extremely otitis-prone children. The findings from this work show that the otitis-prone children not only develop frequent middle-ear diseases, but are also susceptible to other diseases. They exhibited more middle-ear problems than the controls in terms of middle-ear fluid and ventilation tubes, pathological tympanograms and conductive hearing loss. At the follow-up investigation, the extremely otitis-prone children showed improved middle-ear status, but 14% still had problems, and 7% had chronic middle-ear problems. According to our findings, male gender, heredity for recurrent AOM, and poor active tubal function are the most important risk factors regarding otitis-proneness. Perinatal factors, breast-feeding, family size, and the education and occupation of the parents did not reveal any differences between our study groups. Allergy, parental smoking and day-care attendance, as single risk factors seem to be less important, but a combination of the three factors has an additive effect and contribute to otitis-proneness.