Risk factors for otitis media sequelae and chronicity.

Otitis media (OM) is a very common childhood illness, with identified risk factors for chronicity and recurrence. Although a few treatment studies have described clinical factors that predict increased morbidity, there is little information on risk factors for middle ear sequelae of OM. These conditions have an estimated annual incidence of 0.5% to 4% among children with chronic OM with effusion. Prospective studies to identify risk factors for sequelae, although usually preferred by researchers, are expensive to conduct and impractical for rare conditions such as cholesteatoma. Knowledge of risk factors for chronicity and sequelae can be used clinically to target high-risk children for earlier, more aggressive therapy or more frequent surveillance and testing to prevent sequelae and increase early detection of these conditions. A clinician's advice about modifiable risk factors may motivate parents to decrease their child's exposure to factors that increase the risk of OM, OM chronicity, and sequelae. Research is needed to identify risk factors for OM sequelae by means of well-designed controlled studies.