Risk factors for persistent middle-ear effusions. Otitis media, catarrh, cigarette smoke exposure, and atopy

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Abstract
To ascertain risk factors for persistent middle-ear effusions (PMEE), the parents of 2 groups of children were interviewed. The 1st consisted of 76 children with PMEE who were admitted to the hospital for tympanostomy-tube insertion. The 2nd, a control group, consisted of 76 children admitted for other types of surgery, who were matched for age, sex, season and surgical ward. Nearly all (97%) of the children admitted for insertion of tympanostomy tubes and 1 or more episodes of suppurative otitis media. Only 59% of the control children had previous ear infections. Frequent ear infections sharply increased the risk for persistent effusions. Catarrh, household cigarette smoke exposure and atopy also occurred more frequently in children with PMEE. Risk for middle-ear effusions was greatest when these 3 factors were all present. The avoidance of daily exposure to domestic tobacco smoke and, if atopic, of specific allergens shoud be included in the medical treatment of children with PMEE.