Association of recurrent acute otitis media with nasopharynx dimensions in children

1994 ◽  
Vol 108 (4) ◽  
pp. 299-302 ◽  
Author(s):  
Marjo Niemelä ◽  
Matti Uhari ◽  
Pentti Lautala ◽  
Jan Huggare
Keyword(s):  
Confidence Interval ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Lateral Cephalograms ◽  
Recurrent Acute Otitis Media ◽  
Multivariate Modelling ◽  
Almost All ◽  
Recurrent Otitis Media

AbstractThe purpose of this study was to evaluate the hypothesis that the nasopharyngeal anatomy has influence in the risk of recurrent acute otitis media (AOM) attacks. We analysed the occurrence of acute otitis media in 238 healthy schoolchildren who were X-rayed for orthodontic purposes. Six measurements reflecting the size and shape of the bony nasopharynx were recorded from lateral cephalograms. The means for almost all the dimensions of the bony nasopharynx measured were smaller in the children with two or more attacks of AOM in their history than in those with no attack or only one attack. Logistic multivariate modelling showed the distance from the posterior nasal spine to the sella-basion line to be a significant risk factor for recurrent otitis media in girls (difference 1.0 mm; 95 per cent confidence interval 0.1–2.0 mm; p = 0.04) and the shape of the nasopharynx (roundness) in boys (difference 1.9 mm; 95 per cent confidence interval 0.1–4.0 mm; p = 0.01). Measuring the nasopharyngeal bony dimensions may help to identify those children with a risk of recurrent otitis media, at whom prophylactic therapies should be targeted.

A Pacifier Increases the Risk of Recurrent Acute Otitis Media in Children in Day Care Centers

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 884-888 ◽  
Author(s):  
Marjo Niemelä ◽  
Matti Uhari ◽  
Merja Möttönen
Keyword(s):  
Risk Factor ◽  
Relative Risk ◽  
Otitis Media ◽  
Day Care ◽  
Population Attributable Risk ◽  
Acute Otitis Media ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Day Care Centers ◽  
Recurrent Acute Otitis Media

Objective. To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM). Method. In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-month period. Results. More than three attacks of AOM occurred in 29.5% of the children younger than 2 years using pacifiers and in 20.6% of those not doing so (relative risk, 1.6; 95% confidence interval [CI], 0.6, 4.1); in children 2 to 3 years of age, the figures were 30.6% and 13.2%, respectively (relative risk, 2.9; 95% CI, 1.2, 7.3). Logistic modeling with adjustment for age and the duration of monitoring showed the occurrence of AOM to be associated with the time during which a pacifier was used. The use of a pacifier increased the annual incidence of AOM from 3.6 (95% CI, 2.5, 4.9) to 5.4 episodes (4.4, 6.6) in children younger than 2 years and from 1.9 (1.4, 2.5) to 2.7 (2.2, 3.3) in children 2 to 3 years of age. The population-attributable risk of AOM attacks due to the use of a pacifier was 176 attacks, ie, 459 to 635 attacks per year, in the youngest children and 69 attacks, ie, from 264 to 333 attacks per year, in those 2 to 3 years of age. It can be calculated that the use of a pacifier was responsible for 25% of the attacks in children younger than 3 years. Breastfeeding, parental smoking, thumb sucking, using a nursing bottle, and the social class of the family failed to show such strong associations with the occurrence of AOM. Conclusion. We conclude that the use of a pacifier is a significant risk factor for recurrent AOM and suggest that pacifiers should be used only during the first 10 months of life, when need for sucking is strongest, and AOM is uncommon.

scholarly journals Bezold Abscess in a patient with Juvenile Rheumatoid Arthritis

2019 ◽  
Author(s):  
R Fundora ◽  
S Juman ◽  
C Felix ◽  
J Clarke
Keyword(s):  
Rheumatoid Arthritis ◽  
Juvenile Rheumatoid Arthritis ◽  
Otitis Media ◽  
Rare Complication ◽  
Acute Otitis Media ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Mastoid Cavity ◽  
Cortical Mastoidectomy ◽  
History Of

A Bezold abscess is a rare complication of acute otitis media and mastoiditis which is characterized by the collection of pus in the sub-muscular spaces from the mastoid cavity. A 27-year-old female with history of Juvenile Rheumatoid Arthritis presented with right ear discharge and post auricular swelling extending along the sternocleidomastoid muscle. A Bezold abscess was diagnosed upon review of the patient’s CT scan. She subsequently underwent incision and drainage of the abscess in addition to a cortical mastoidectomy. Although the development of intra and extra axial complications of acute otitis media are very rare in the post antibiotic and vaccination era, it should be noted that a compromised immune system is a significant risk factor for this complication.

Does Acute Otitis Media in the First Month of Life Increase the Risk for Recurrent Otitis?

2017 ◽  
Vol 57 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Orli Megged ◽  
Suzan Abdulgany ◽  
Maskit Bar-Meir
Keyword(s):  
Otitis Media ◽  
Medical Records ◽  
Odds Ratio ◽  
Acute Otitis Media ◽  
Significant Risk ◽  
Bacterial Pathogen ◽  
Significant Risk Factor ◽  
Childhood Illness ◽  
Control Group ◽  
Middle Ear Fluid

Acute otitis media (AOM) is a common childhood illness. The aim of this study was to assess whether AOM in the first month of life predicts recurrent AOM (rAOM) in early childhood. The medical records of all neonates with AOM and isolation of bacterial pathogen from middle-ear fluid during 2005-2010 were reviewed. Neonates without AOM admitted during the same period for neonatal fever workup were included as controls. Information regarding rAOM and possible risk factors were collected through a phone interview with the parents. A total of 84 neonates with AOM were enrolled; 25 (30%) had rAOM compared with 8/79 (10%) in the control group. Neonatal AOM increases 4-fold the odds of rAOM later in childhood (odds ratio = 4; 95% CI = 1.44-11.42; P = .008), independent of smoke exposure, numbers of siblings, AOM in siblings, breastfeeding, day care attendance, or use of pacifier. Neonatal AOM is a significant risk factor for rAOM during infancy.

Recurrent Acute Otitis Media: The Significance of Age at Onset

1997 ◽  
Vol 117 (4) ◽  
pp. 578-584 ◽  
Author(s):  
Kari J. Kværner ◽  
Per Nafstad ◽  
Jørgen A. Hagen ◽  
Iain W. S. Mair ◽  
Jouni J. K. Jaakkola
Keyword(s):  
Otitis Media ◽  
Age At Onset ◽  
Acute Otitis Media ◽  
Recurrent Acute Otitis Media

scholarly journals Comparative study of once-weekly azithromycin and once-daily amoxicillin treatments in prevention of recurrent acute otitis media in children.

1996 ◽  
Vol 40 (12) ◽  
pp. 2732-2736 ◽  
Author(s):  
P Marchisio ◽  
N Principi ◽  
E Sala ◽  
L Lanzoni ◽  
S Sorella ◽  
...  
Keyword(s):  
Otitis Media ◽  
Randomized Study ◽  
Acute Otitis Media ◽  
Occurrence Rate ◽  
Once Daily ◽  
Recurrent Acute Otitis Media ◽  
Periodic Administration ◽  
Resistant Strains ◽  
Selection Of

Continuous chemoprophylaxis is effective in the prevention of new episodes of acute otitis media (AOM) in otitis-prone children, but compliance can be a problem and thus efficacy can be decreased. Intermittent chemoprophylaxis has so far shown conflicting results. Azithromycin, which has a peculiar pharmacokinetics, resulting, even after a single dose, in persistently elevated concentrations in respiratory tissues, could permit a periodic administration with higher compliance. We compared a 6-month course of once-weekly azithromycin (5 or 10 mg/kg of body weight) with that of once-daily amoxicillin (20 mg/kg) in a single-blind, randomized study of prophylaxis for recurrent AOM in 159 children aged 6 months to 5 years with at least three episodes of AOM in the preceding 6 months. In the amoxicillin group, 23 (31.1%) of 74 children developed 29 episodes of AOM, while in the 10-mg/kg azithromycin group, 11 (14.9%) of 74 children experienced 15 episodes. The 5-mg/kg/week azithromycin trial was prematurely interrupted after nine cases, due to the high occurrence rate of AOM (55.5%). During the 6-month prophylaxis period, the proportion of children with middle ear effusion declined similarly in both groups. No substantial modification of the nasopharyngeal flora was noted at the end of prophylaxis in both antimicrobial groups. In the 6-month-postprophylaxis follow-up period, about 40% of children in both groups again developed AOM. Azithromycin at 10 mg/kg once weekly can be regarded as a valid alternative to once-daily low-dose amoxicillin for the prophylaxis of AOM. Although in the present study no microbiological drawback was noted, accurate selection of children eligible for prophylaxis is mandatory to avoid the risk of emergence of resistant strains.

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