title: Assessment of the association between atopic conditions and tympanostomy tube placement in children.
abstract: This study assesses the relationship between otitis media and atopic conditions in children by comparing the incidence of tympanostomy tube placement between children with and without atopic conditions: asthma, allergic rhinitis, and atopic dermatitis. Study subjects were a cohort of  323 healthy children who participated in a study of vaccine response. All episodes of tympanostomy tube placement and physician diagnoses of allergic rhinitis and atopic dermatitis were collected through comprehensive medical record review. Asthma status was ascertained through application  of established criteria. We compared incidence rates of tympanostomy tube placement between children with and without atopic conditions. We fitted data to a Poisson regression model to calculate relative risk ratios (RRs) and their corresponding 95% confidence intervals (95% CI). Three subjects  were excluded who did not have parental authorization for using records for research. Of the remaining 320 subjects, 170 (53%) were male subjects, 268 (94%) were white, 124 (39%) were asthmatic patients, and 20 (6%) had tympanostomy tube placement. Children with asthma before the index date  of tympanostomy tube placement were more likely to have tympanostomy tube placement compared with those without asthma (RR, 19.33; 95% CI, 11.41; 32.75; p < 0.001). We found a similar association between asthma ever (before or after index date) and the incidence of tympanostomy tube placement  (RR, 1.53; 95% CI, 0.93-2.53; p = 0.095). This was true for children with allergic rhinitis compared with those without allergic rhinitis (RR, 1.70; 95% CI, 1.01-2.86; p = 0.007). Atopic dermatitis was not associated with the incidence of tympanostomy tube placement. Asthma or  allergic rhinitis may be unrecognized risk factors for recurrent or persistent otitis media. However, given the small sample size of the study, a cohort study with a larger sample size is necessary.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Kara A
authors.initials: KA
authors.lastname: Bjur
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Lynch
authors.forename: Yilma A
authors.initials: YA
authors.lastname: Fenta
authors.forename: Kwang Ha
authors.initials: KH
authors.lastname: Yoo
authors.forename: Robert M
authors.initials: RM
authors.lastname: Jacobson
authors.forename: Xujian
authors.initials: X
authors.lastname: Li
authors.forename: Young J
authors.initials: YJ
authors.lastname: Juhn
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology* / Q000209:etiology*; D015994:Incidence; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment