Prevalence and risk factors of otitis media with effusion in children with obstructive sleep apnea

OBJECTIVE: The aim of this study was to investigate the correlation between obstructive sleep apnea (OSA) and otitis me-dia with effusion (OME) in Chinese children and identify risk factors for OME to support the de-velopment of standardized diagnostic and treat-ment methods.PATIENTS AND METHODS: Clinical data of 1,021 children with OSA admitted to our hospital between January 2019 and December 2020 were collected. The prevalence of OME was assessed based on age groups and different grades of ad-enoid hypertrophy (AH). Multivariate logistic re-gression was performed to determine risk fac-tors for OME in this population.RESULTS: Among the patients, only 73 (6.15%) reported hearing loss as the main com-plaint, while 178 (17.43%) were diagnosed with OME after the examination. Acoustic immittance showed higher detection rates for OME com-pared to those of otoscopy and pure tone au-diometry. In addition, the incidence of OME did not increase with AH grade but was higher in children with OSA with AH grade IV. Multivari-ate regression analysis showed that the younger age group (2-5 years), AH grade IV, nasal inflam-matory disease, and passive smoking were sig-nificant risk factors for OSA and OME. However, sex, age of 6-12 years, and presence of chron-ic tonsillitis/tonsillar hypertrophy had no signifi-cant impact on the prevalence of OME. CONCLUSIONS: OME is highly prevalent in children with OSA. Clinicians should be vigilant in diagnosing OME, should conduct routine au-diological examinations, and actively screen for middle ear fluid in all children with OSA, espe-cially in younger children (2-5 years) with nasal mucosa inflammation and a history of passive smoking. This will help improve the detection rate of OME, as early intervention is paramount for preventing complications.