Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
Department of Otorhinolaryngology and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
Ear Hear. 2020 Jan/Feb;41(1):67-71. doi: 10.1097/AUD.0000000000000729.
The pathogenesis of chronic suppurative otitis media (CSOM) includes complex interactions between microbial, immunologic, and genetic factors. To our knowledge, no study has focused on the association between childhood otitis media, immune regulation, inflammatory conditions, and chronic disease in adulthood. The present study aims to assess whether CSOM in childhood predicts immune-related inflammatory disorders or cardiovascular disease in adulthood. Another aim is to assess the association with oto-vestibular diseases in adulthood.
Population cohort study in Norway comprised 51,626 participants (mean age 52 years) who underwent a hearing investigation at 7 to 13 years of age where 189 were diagnosed with CSOM (otorhinolaryngologist diagnose) and 51,437 had normal hearing thresholds (controls). Data on adult disease were obtained from the Norwegian Patient Registry (ICD-10 codes from the specialist health services). We estimated associations with logistic regression analyses.
The associations between CSOM in childhood and disease in adulthood were as follows: chronic sinusitis (odds ratio 3.13, 95% confidence interval 1.15 to 8.52); cardiovascular disease (1.38, 1.01 to 1.88); hearing loss (5.58, 3.78 to 8.22); tinnitus (2.62, 1.07 to 6.41). The adult hearing loss among cases with childhood CSOM was most frequently registered as sensorineural. There was no statistically significant increased risk of later asthma (1.84 [0.98 to 3.48]), inflammatory bowel disease, inflammatory joint disease, systemic tissue disease, or vestibulopathy. The estimates were adjusted for age, sex, socio-economic status, and smoking.
Our large cohort study, which is the first to focus on the link between otitis media in childhood and immune-related inflammatory disorders later in life, does not confer a clear association. CSOM in childhood was strongly related to adult tinnitus and hearing loss, which was most frequently registered as sensorineural.
慢性化脓性中耳炎（CSOM）的发病机制包括微生物、免疫和遗传因素之间的复杂相互作用。据我们所知，尚无研究关注儿童中耳炎、免疫调节、炎症状态与成年期慢性疾病之间的关系。本研究旨在评估儿童期 CSOM 是否可预测成年期与免疫相关的炎症性疾病或心血管疾病。另一个目的是评估与成年期耳-前庭疾病的相关性。
挪威的一项人群队列研究纳入了 51626 名参与者（平均年龄 52 岁），他们在 7 至 13 岁时接受了听力检查，其中 189 名被诊断为 CSOM（耳鼻喉科医生诊断），51437 名听力正常（对照组）。成人疾病数据来自挪威患者登记处（专科卫生服务的 ICD-10 编码）。我们使用逻辑回归分析来评估相关性。
儿童期 CSOM 与成年期疾病之间的关联如下：慢性鼻窦炎（比值比 3.13，95%置信区间 1.15 至 8.52）；心血管疾病（1.38，1.01 至 1.88）；听力损失（5.58，3.78 至 8.22）；耳鸣（2.62，1.07 至 6.41）。患有儿童 CSOM 的成年人中，听力损失主要是感音神经性的。后期哮喘（1.84[0.98 至 3.48]）、炎症性肠病、炎性关节病、全身性组织疾病或前庭病的发病风险无统计学显著增加。这些估计值经过年龄、性别、社会经济地位和吸烟因素的调整。
我们的大型队列研究首次关注儿童中耳炎与成年后与免疫相关的炎症性疾病之间的联系，结果没有明确的相关性。儿童期 CSOM 与成年期耳鸣和听力损失密切相关，其中听力损失主要是感音神经性的。
