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Risk factors for recurrent acute otitis media: a real-life clinical experience
G Ciprandi1, F Ameli2, A Asmanov3
1Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy.
Insights
Recurrent acute otitis media (RAOM) in children is linked to female gender, artificial feeding, and enlarged tonsils/adenoids. Interventions targeting tonsil and adenoid size may help reduce RAOM occurrences.
Area of Science:
- Pediatrics
- Otolaryngology
- Infectious Diseases
Background:
- Acute otitis media (AOM) is a common childhood bacterial infection.
- Recurrent AOM (RAOM) presents a significant clinical challenge, with risk factors under ongoing investigation.
- Identifying predictive factors for RAOM is crucial for effective management in pediatric populations.
Purpose of the Study:
- To identify clinical and endoscopic predictors of RAOM in children within a real-world otorhinolaryngologic (ORL) clinic setting.
- To investigate the association between specific patient characteristics and the recurrence of AOM.
- To provide practical insights for managing RAOM in primary care.
Main Methods:
- A consecutive cohort of 1,002 children presenting with upper airway symptoms were evaluated.
- Detailed clinical histories were collected, and nasal endoscopy was performed for each child.
- Statistical analysis was conducted to determine factors associated with RAOM.
Main Results:
- Female gender, artificial feeding, and tonsillar and adenoid hypertrophy were identified as significant risk factors for RAOM.
- These factors were found to be significantly associated with the recurrence of AOM in the studied cohort.
- Endoscopic findings and clinical data provided valuable information for predicting RAOM.
Conclusions:
- Female gender, artificial feeding, and adenoid/tonsillar hypertrophy are key predictors of RAOM in children.
- Strategies aimed at reducing adenoid and tonsil size, potentially with topical corticosteroids or glycyrrhizin, may mitigate RAOM.
- Real-world clinical data from ORL settings can yield clinically relevant information for managing pediatric RAOM.
Abstract:
Acute otitis media (AOM) is the most common bacterial infection in children. Some children with AOM tend to be otitis-prone, such as frequent recurrence of AOM (RAOM). Possible RAOM risk factors are widely debated. The current study was performed in a real-life setting, such as an otorhinolaryngologic (ORL) clinic, to identify predictive factors, including clinical data and endoscopic findings, for RAOM in children. In this study, 1,002 children (550 males, 452 females, mean age 5.77 + 1.84 years) complaining of upper airway symptoms were consecutively visited. Detailed clinical history and nasal endoscopy were performed. Throughout the ORL visit, it was possible to define some factors involved in the recurrence of AOM, including female gender, artificial feeding, tonsillar and adenoid hypertrophy. Adenoid and tonsillar hypertrophy, female gender, and artificial are factors significantly associated with RAOM. Therefore, reducing adenoid and tonsil size, also using topical corticosteroids or glycyrrhizin, could be a reasonable strategy to potentially reduce adenoid and tonsil size. The current study suggests that also in a primary care setting, it is possible to achieve meaningful information that is relevant in clinical practice.
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