Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland.
JAMA Otolaryngol Head Neck Surg. 2023 Jul 1;149(7):587-596. doi: 10.1001/jamaoto.2023.0841.
Otologic disease is common among people with primary ciliary dyskinesia (PCD), yet little is known about its spectrum and severity.
To characterize otologic disease among participants with PCD using data from the Ear-Nose-Throat Prospective International Cohort.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis of baseline cohort data from February 2020 through July 2022 included participants from 12 specialized centers in 10 countries. Children and adults with PCD diagnoses; routine ear, nose, and throat examinations; and completed symptom questionnaires at the same visit or within 2 weeks were prospectively included.
Potential risk factors associated with increased risk of ear disease.
The prevalence and characteristics of patient-reported otologic symptoms and findings from otologic examinations, including potential factors associated with increased risk of ear inflammation and hearing impairment.
A total of 397 individuals were eligible to participate in this study (median [range] age, 15.2 [0.2-72.4] years; 186 (47%) female). Of the included participants, 204 (51%) reported ear pain, 110 (28%) reported ear discharge, and 183 (46%) reported hearing problems. Adults reported ear pain and hearing problems more frequently when compared with children. Otitis media with effusion-usually bilateral-was the most common otoscopic finding among 121 of 384 (32%) participants. Retracted tympanic membrane and tympanic sclerosis were more commonly seen among adults. Tympanometry was performed for 216 participants and showed pathologic type B results for 114 (53%). Audiometry was performed for 273 participants and showed hearing impairment in at least 1 ear, most commonly mild. Season of visit was the strongest risk factor for problems associated with ear inflammation (autumn vs spring: odds ratio, 2.40; 95% CI, 1.51-3.81) and age 30 years and older for hearing impairment (41-50 years vs ≤10 years: odds ratio, 3.33; 95% CI, 1.12-9.91).
In this cross-sectional study, many people with PCD experienced ear problems, yet frequency varied, highlighting disease expression differences and possible clinical phenotypes. Understanding differences in otologic disease expression and progression during lifetime may inform clinical decisions about follow-up and medical care. Multidisciplinary PCD management should be recommended, including regular otologic assessments for all ages, even without specific complaints.
耳科学疾病在原发性纤毛运动障碍(PCD)患者中很常见,但人们对其谱系和严重程度知之甚少。
利用耳鼻喉前瞻性国际队列的数据,描述 PCD 患者的耳科疾病特征。
设计、地点和参与者:本项研究为 2020 年 2 月至 2022 年 7 月的基线队列数据的横断面分析,纳入了来自 10 个国家 12 个专门中心的参与者。在同一就诊时或 2 周内进行了 PCD 诊断的儿童和成人、常规耳鼻喉检查以及完成症状问卷的患者被前瞻性纳入。
与耳部疾病风险增加相关的潜在危险因素。
患者报告的耳部症状和耳部检查结果的流行率和特征,包括与耳部炎症和听力损伤风险增加相关的潜在因素。
共有 397 名符合条件的参与者参加了这项研究(中位数[范围]年龄,15.2[0.2-72.4]岁;186[47%]为女性)。纳入的参与者中,204 名(51%)报告耳部疼痛,110 名(28%)报告耳部排出物,183 名(46%)报告听力问题。与儿童相比,成年人更常报告耳部疼痛和听力问题。中耳炎伴积液-通常为双侧-是 384 名参与者中的 121 名(32%)最常见的耳镜检查结果。鼓膜内陷和鼓膜硬化在成年人中更为常见。对 216 名参与者进行了鼓室图测试,114 名(53%)显示为病理性 B 型结果。对 273 名参与者进行了听力测试,至少 1 只耳朵存在听力障碍,最常见的是轻度听力障碍。就诊季节是与耳部炎症相关问题的最强危险因素(秋季与春季相比:比值比,2.40;95%CI,1.51-3.81),30 岁及以上年龄是听力障碍的最强危险因素(41-50 岁与≤10 岁相比:比值比,3.33;95%CI,1.12-9.91)。
在这项横断面研究中,许多 PCD 患者存在耳部问题,但频率不同,突出了疾病表现的差异和可能的临床表型。了解一生中耳科疾病表现和进展的差异可能有助于为随访和医疗护理做出临床决策。应推荐多学科 PCD 管理,包括对所有年龄段的常规耳部评估,即使没有具体的投诉。