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==Overview==
==Overview==
Children below the age of seven years are much more prone to otitis media since the [[Eustachian tube]] is shorter and at more of a horizontal angle than in the adult ear. They also have not developed the same resistance to viruses and bacteria as adults. Numerous studies have correlated the incidence of acute otitis media in children with various factors such as nursing in infancy, bottle feeding when supine, parental smoking, diet, allergies and automobile emissions; but the most obvious weakness of such studies is the inability to control the variable of exposure to viral agents during the studies.  One must also keep in mind that [[Correlation does not imply causation|correlation does not establish causation]].  Breastfeeding for the first twelve months of life is associated with a reduction in the number and duration of all otitis media infections.<ref name="pmid7751991">{{cite journal |author=Dewey KG, Heinig MJ, Nommsen-Rivers LA |title=Differences in morbidity between breast-fed and formula-fed infants |journal=J. Pediatr.|volume=126 |issue=5 Pt 1 |pages=696–702 |year=1995 |pmid=7751991 |doi=}}</ref>
The most potent risk factor for otitis media is age, specifically being younger than 5 years old. Other common risk factors include exposure to smoke and air pollution, [[malnutrition]], lack of breastfeeding, enrollment in daycare, [[allergies]] or recurrent [[upper respiratory infections]], living in cold climates or climates subject to sudden changes, being a male younger than 20 months old, and being of Caucasian, Greenlandic, Southeast Asian, or Sub-Saharan West African descent.


==Risk Factors==
==Risk Factors==
Infants and young children are especially susceptible to ear infections.
*Being a child under 5 years old.<ref name="pmid22558393">{{cite journal |vauthors=Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, Grasso D, Barbiero C, Tamburlini G |title=Burden of disease caused by otitis media: systematic review and global estimates |journal=PLoS ONE |volume=7 |issue=4 |pages=e36226 |year=2012 |pmid=22558393 |pmc=3340347 |doi=10.1371/journal.pone.0036226 |url=}}</ref>
 
*Smoking, or exposure to secondhand smoke.
There are many reasons why children are more likely to suffer from otitis media than adults. First, children have more trouble fighting infections. This is because their immune systems are still developing. Another reason has to do with the child's eustachian tube. The eustachian tube is a small passageway that connects the upper part of the throat to the middle ear. It is shorter and straighter in the child than in the adult. It can contribute to otitis media in several ways.
*Exposure to air pollution
 
*Suffering from [[malnutrition]]
The eustachian tube is usually closed but opens regularly to ventilate or replenish the air in the middle ear. This tube also equalizes middle ear air pressure in response to air pressure changes in the environment. However, a eustachian tube that is blocked by swelling of its lining or plugged with mucus from a cold or for some other reason cannot open to ventilate the middle ear. The lack of ventilation may allow fluid from the tissue that lines the middle ear to accumulate. If the eustachian tube remains plugged, the fluid cannot drain and begins to collect in the normally air-filled middle ear.
*Being born in the winter or spring.<ref name="pmid21886448">{{cite journal |vauthors=Macintyre EA, Karr CJ, Koehoorn M, Demers P, Tamburic L, Lencar C, Brauer M |title=Otitis media incidence and risk factors in a population-based birth cohort |journal=Paediatr Child Health |volume=15 |issue=7 |pages=437–42 |year=2010 |pmid=21886448 |pmc=2948776 |doi= |url=}}</ref>
 
**Exclusively applies to first 12 months of life.
One more factor that makes children more susceptible to otitis media is that adenoids in children are larger than they are in adults. Adenoids are composed largely of cells (lymphocytes) that help fight infections. They are positioned in the back of the upper part of the throat near the eustachian tubes. Enlarged adenoids can, because of their size, interfere with the eustachian tube opening. In addition, adenoids may themselves become infected, and the infection may spread into the eustachian tubes.
*Not being [[Breastfeeding|breastfed]]
 
*Being a child in daycare.<ref name="urlEar infection - acute: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000638.htm |title=Ear infection - acute: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
Bacteria reach the middle ear through the lining or the passageway of the eustachian tube and can then produce infection, which causes swelling of the lining of the middle ear, blocking of the eustachian tube, and migration of white cells from the bloodstream to help fight the infection. In this process the white cells accumulate, often killing bacteria and dying themselves, leading to the formation of pus, a thick yellowish-white fluid in the middle ear. As the fluid increases, the child may have trouble hearing because the eardrum and middle ear bones are unable to move as freely as they should. As the infection worsens, many children also experience severe ear pain. Too much fluid in the ear can put pressure on the eardrum and eventually tear it.
*Family history of ear infections.
*Living in cold climates or experiencing sudden changes in climate.
*Being Caucasian, Southeast Asian, Greenlandic or Sub-Saharan West African.<ref name="LowyZhang2014">{{cite journal|last1=Lowy|first1=Franklin D.|last2=Zhang|first2=Yan|last3=Xu|first3=Min|last4=Zhang|first4=Jin|last5=Zeng|first5=Lingxia|last6=Wang|first6=Yanfei|last7=Zheng|first7=Qing Yin|title=Risk Factors for Chronic and Recurrent Otitis Media–A Meta-Analysis|journal=PLoS ONE|volume=9|issue=1|year=2014|pages=e86397|issn=1932-6203|doi=10.1371/journal.pone.0086397}}</ref>
*Being a male below 20 months old.
*Being [[immunocompromised]].
*Recurrent [[upper respiratory infections]] for chronic [[suppurative]] otitis media.<ref name="pmid19454051">{{cite journal |vauthors=Acuin J |title=Chronic suppurative otitis media |journal=BMJ Clin Evid |volume=2007 |issue= |pages= |year=2007 |pmid=19454051 |pmc=2943814 |doi= |url=}}</ref>
*Experiencing [[allergies]].


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}
[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
[[Category:Inflammations]]
[[Category:Inflammations]]
[[Category:Otolaryngology]]
[[Category:Otolaryngology]]
[[Category:Otology]]
[[Category:Otology]]
[[Category:Pediatrics]]
[[Category:Pediatrics]]
{{WH}}
{{WS}}

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.; Hardik Patel, M.D.

Overview

The most potent risk factor for otitis media is age, specifically being younger than 5 years old. Other common risk factors include exposure to smoke and air pollution, malnutrition, lack of breastfeeding, enrollment in daycare, allergies or recurrent upper respiratory infections, living in cold climates or climates subject to sudden changes, being a male younger than 20 months old, and being of Caucasian, Greenlandic, Southeast Asian, or Sub-Saharan West African descent.

Risk Factors

  • Being a child under 5 years old.[1]
  • Smoking, or exposure to secondhand smoke.
  • Exposure to air pollution
  • Suffering from malnutrition
  • Being born in the winter or spring.[2]
    • Exclusively applies to first 12 months of life.
  • Not being breastfed
  • Being a child in daycare.[3]
  • Family history of ear infections.
  • Living in cold climates or experiencing sudden changes in climate.
  • Being Caucasian, Southeast Asian, Greenlandic or Sub-Saharan West African.[4]
  • Being a male below 20 months old.
  • Being immunocompromised.
  • Recurrent upper respiratory infections for chronic suppurative otitis media.[5]
  • Experiencing allergies.

References

  1. ↑ Monasta L, Ronfani L, Marchetti F, Montico M, Vecchi Brumatti L, Bavcar A, Grasso D, Barbiero C, Tamburlini G (2012). "Burden of disease caused by otitis media: systematic review and global estimates". PLoS ONE. 7 (4): e36226. doi:10.1371/journal.pone.0036226. PMC 3340347. PMID 22558393.
  2. ↑ Macintyre EA, Karr CJ, Koehoorn M, Demers P, Tamburic L, Lencar C, Brauer M (2010). "Otitis media incidence and risk factors in a population-based birth cohort". Paediatr Child Health. 15 (7): 437–42. PMC 2948776. PMID 21886448.
  3. ↑ "Ear infection - acute: MedlinePlus Medical Encyclopedia".
  4. ↑ Lowy, Franklin D.; Zhang, Yan; Xu, Min; Zhang, Jin; Zeng, Lingxia; Wang, Yanfei; Zheng, Qing Yin (2014). "Risk Factors for Chronic and Recurrent Otitis Media–A Meta-Analysis". PLoS ONE. 9 (1): e86397. doi:10.1371/journal.pone.0086397. ISSN 1932-6203.
  5. ↑ Acuin J (2007). "Chronic suppurative otitis media". BMJ Clin Evid. 2007. PMC 2943814. PMID 19454051.

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