Many factors influence the development of otitis media with effusion (OME) in children, some of them being increased plasminogen factor inhibitor (PAI-1) levels, eustachian tube obstruction and gastro-oesophageal reflux. These factors are also associated with obesity. Sixty children with mean age of 6.34 years, suffering from OME were compared with 86 age and sex matched control group children. The parameters used for obesity were BMI, weight for height value and ‘weight z’ score. The results showed a higher prevalence of obesity in the OME group compared to the control group. The study also assessed tonsillar and adenoid hypertrophy, the latter by occlusion of the nasopahrynx in quartiles, but neither of these showed any clear association with obesity. Therefore, whether obesity is simply associated with OME or leads to it is not concluded in this study. The issue is slightly confounded by the presence of unilateral cases which constituted 48% of the study group. The article provides an interesting review of the literature showing variable results in similar studies. One study showed an association between 75-100% choanal obstruction and low BMI, a possible reason being that airway obstruction interferes with weight gain. Further research is needed to pinpoint the pathophysiology of obesity and its specific effect on the middle ear. One perspective which emerges is the possible role of anti-reflux measures in obese children with OME to achieve better results.

Relationship between chronic otitis media with effusion and overweight or obesity in children.
Kaya S Selimoglu E, Cureoglu S, Selimoglu MA.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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