Abstract
Objectives
Chronic suppurative otitis media (CSOM) is defined as persistent discharge through a tympanic membrane perforation for greater than 2 weeks. It is associated with a significant disease burden, including hearing loss, and reducing its incidence could significantly improve short- and long-term health. We aimed to identify risk factors associated with the development of CSOM in children.
Design and Setting
Systematic review and meta-analysis of studies set in community, primary and secondary care settings, identified from Medline, Embase and Cochrane databases from 2000 to 2022.
Participants
Children 16 years old and below.
Main Outcome Measures
Clinical diagnosis of CSOM.
Results
In total, 739 papers were screened, with 12 deemed eligible for inclusion in the systematic review, of which, 10 were included in the meta-analysis. Risk factors examined included perinatal, patient, dietary, environmental and parental factors. Meta-analysis results indicate that atopy (RR = 1.18, 95% CI [1.01–1.37], p = .04, 2 studies); and birth weight <2500 g (RR = 1.79 [1.27–2.50], p < .01, 2 studies) are associated with an increased risk of CSOM development. Factors not associated were male sex (RR = 0.96 [0.82–1.13], p = .62, 8 studies); exposure to passive smoking (RR = 1.27 [0.81–2.01], p = .30, 3 studies); and parental history of otitis media (RR = 1.14 [0.59–2.20], p = .69, 2 studies).
Conclusion
Optimal management of risk factors associated with CSOM development will help reduce the burden of disease and prevent disease progression or recurrence. The current quality of evidence in the literature is variable and heterogeneous. Future studies should aim to use standardised classification systems to define risk factors to allow meta-analysis.
Chronic suppurative otitis media (CSOM) is defined as persistent discharge through a tympanic membrane perforation for greater than 2 weeks. It is associated with a significant disease burden, including hearing loss, and reducing its incidence could significantly improve short- and long-term health. We aimed to identify risk factors associated with the development of CSOM in children.
Design and Setting
Systematic review and meta-analysis of studies set in community, primary and secondary care settings, identified from Medline, Embase and Cochrane databases from 2000 to 2022.
Participants
Children 16 years old and below.
Main Outcome Measures
Clinical diagnosis of CSOM.
Results
In total, 739 papers were screened, with 12 deemed eligible for inclusion in the systematic review, of which, 10 were included in the meta-analysis. Risk factors examined included perinatal, patient, dietary, environmental and parental factors. Meta-analysis results indicate that atopy (RR = 1.18, 95% CI [1.01–1.37], p = .04, 2 studies); and birth weight <2500 g (RR = 1.79 [1.27–2.50], p < .01, 2 studies) are associated with an increased risk of CSOM development. Factors not associated were male sex (RR = 0.96 [0.82–1.13], p = .62, 8 studies); exposure to passive smoking (RR = 1.27 [0.81–2.01], p = .30, 3 studies); and parental history of otitis media (RR = 1.14 [0.59–2.20], p = .69, 2 studies).
Conclusion
Optimal management of risk factors associated with CSOM development will help reduce the burden of disease and prevent disease progression or recurrence. The current quality of evidence in the literature is variable and heterogeneous. Future studies should aim to use standardised classification systems to define risk factors to allow meta-analysis.
| Original language | English |
|---|---|
| Pages (from-to) | 62-73 |
| Number of pages | 12 |
| Journal | Clinical Otolaryngology |
| Volume | 49 |
| Issue number | 1 |
| Early online date | 5 Oct 2023 |
| DOIs | |
| Publication status | E-pub ahead of print - 5 Oct 2023 |
Bibliographical note
Publisher Copyright:© 2023 The Authors. Clinical Otolaryngology published by John Wiley & Sons Ltd.