Ercan KURT, Fatih ÇELENK, Burhanetin GÖNÜLDAŞ, Koray TÜMÜKLÜ

Çocuklarda Kronik Otitis Media için Sosyodemografik, Sosyoekonomik ve Klinik Risk Faktörleri

Amaç: Bu çalışmanın amacı çocuklarda KOM ile ilişkili klinik, sosyodemografik ve sosyoekonomik risk faktörlerini belirlemektir.Metot: Bu çalışmaya 2005-2015 yılları arasında Gaziantep Üniversitesi Tıp Fakültesi KBB Anabilim Dalı’nda KOM tanı ve tedavisi almış 103 çocuk hasta ve 116 sağlıklı çocuk dahil edildi. Risk faktörlerini içeren anketler hasta ve kontrol grubundaki çocukların anne ve/veya babası ile birebir görüşülerek dolduruldu. Bulgular: Hastaların 53’ü erkek (%51,5) ve 50’si kızdı (%48,5). Kontrol grubunda 48 erkek (%41,4) ve 68 kız (%58,6) çocuk bulunmaktaydı. Hastaların yaş ortalaması 13,1 (yaş aralığı, 2-16) ve kontrol grubunun yaş ortalaması 12,05 (yaş aralığı, 6-16) idi. Belirlenen risk faktörleri ile KOM arasındaki ilişkiyi belirlemek için çok değişkenli regresyon modeli ve tek değişkenli analiz kullanıldı. Annenin gebelikte sigara kullanması (p=0,014), ilk yaşta otitis media geçirme (p=0,001), sık otitis media geçirme (p=0,001), ilk yaşta sık üst solunum yolu enfeksiyonu geçirme (p=0,001), önceki kulak zarına ventilasyon tüpü tatbiki (p=0.001), önceki tonsillektomi ve/veya adenoidektomi (p=0,001), babada (p=0.008) ve kardeşte otitis media hikayesi (p=0,008) ve aile reisinin sigortasının olmaması (p=0.001) KOM ile anlamlı olarak ilişkili bulundu. Çok-değişkenli analizde ilk yaşta otitis media geçirme (OR=8,00, %95 GA=[3,34-19,17], p=0.000), babada otitis media hikayesi (OR=8,438, %95 GA=[1,47-48,42], p=0.017) ve aile reisinin sağlık güvencesinin olmaması (OR=3,091 %95 GA=[1,35-7,110], p=0.008) KOM ile ilişkili risk faktörleri olarak bulundu. Sonuç: Kronik otitis media (KOM) orta kulağın kulak zarında kalıcı değişikliklere yol açan uzun süreli enflamasyonudur. KOM çocuklarda sık görülen bir hastalıktır ve tam olarak tedavi edilmezse ciddi komplikasyonlara ve sekellere yol açabilir. Bu hastalıkla ilişkili risk faktörleri ortaya konulursa potansiyel komplikasyonlar önlenebilir ve önleyici stratejiler geliştirilir. Bu çalışmada elde edilen sonuçlara göre ilk yaşta otitis media geçirme, babada otitis media hikayesi aile reisinin sağlık güvencesinin olmaması KOM için risk faktörleridir.

Anahtar Kelimeler:

Aktif kronik otitis media, İnaktif kronik otitis media, Risk faktörleri

Sociodemographic, Socioeconomic and Clinical Risk Factors for Chronic Otitis Media in Childreen

Aim:The aim of present study is to identify COM-related clinic, sociodemographic and socioeconomic risk factors.Method: 103 children diagnosed for COM and treated in Department of Otorhinolaryngology, Faculty of Medicine, Gaziantep University during 2005-2015 and 116 healthy children were included in this study. The questionnaire about risk factors of COM were filled by interviewing verbatim with mothers and/or fathers of all children. Result: Patient and control groups were composed of 53 boys (51.5%) and 50 girls (48.5%), and 48 boys (41.4%) and 68 girls (58.6%), respectively. The mean age of patients was 13.1 years (range, 2-16), and the mean age of the control group was 12.05 years (range, 6-16). Multiple logistic regression models and univariate analysis were used to determine association between risk factors and COM. Maternal smoking during pregnancy (p=0.014), otitis media history in the first year of life (p=0.001), recurrent otitis media history (p=0.001), upper respiratory tract infection history in the first year of life (p=0.001), ventilation tube insertion history (p=0.001), tonsillectomy and/or adenoidectomy history (p=0.001), otitis media history in family members (p=0.008) and lack of health insurance (p=0.001) were found to be significantly associated with COM. In multivariate analysis, otitis media history in the first year of life (OR=8,00, %95 CI= [3,34-19,17], p=0.001), father’s otitis media history (OR=8.43, %95 CI= [1,47-48,42], p=0.017) and lack of health insurance (OR=3,09 %95 CI=[1,35-7,11], p=0.008) were significantly associated with COM. Conclusion: Chronic otitis media (COM) is a long-term inflammation of middle ear that leads to irreversible changes in eardrum. COM is a common disease in children, and if not treated, it may cause severe complications and sequelae. Thus, if risk factors causing COM are elucidated, the potential complications might be prevented and prophylactic strategies can be developed. This study indicated that history of otitis media in the first year of life, having a father with history of otitis media and lack of health insurance are risk factors for COM.

Keywords:

Chronic otitis media, Otitis media, risc factors,

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