Otitis media history, surgery and allergy in 60-year perspective: a population-based study

Objectives: To assess the relationship between recurrent otitis media (OM), OM surgery and allergy in a 60-years perspective in the general population.

Methods: A cross-sectional questionnaire study of 40,000 randomly selected Norwegians aged 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75 and 80 years stratified by age and gender in 2005, i.e. each age group 30-60 years included 2000 and the remaining age groups 1000 persons of each gender. Main outcome measures were recurrent childhood OM, childhood myringotomy, ventilation tubes or adenoidectomy and lifetime allergy.

Results: The prevalence of recurrent OM was 24.3% (n=4823) and OM surgery 12.4% (n=2499). An increase in the proportion of OM surgery by age cohort was found, with the highest surgery rate of 0.52 for the 1955 age cohort, followed by a gradual decrease until the 1980 age cohort, when surgery stabilized at 0.42. Recurrent OM and OM surgery was more common in respondents with allergy. Among the latter, the probability for OM surgery was almost threefold when the age cohort 1945 was compared to 1920, OR(adj) at 2.95 (1.59-5.48). The latter tendency remained strong until 1965. Among non-allergics, the increase in surgery probability by age cohort showed the same tendency, but the relationship was less strong than for those with allergy.

Conclusions: Despite a twofold increase in recurrent OM and OM surgery from 1925 to 1945, the proportion of OM and OM surgery have been stable since 1945. Our findings suggest a shift in clinical practice, most likely indicating a change in surgery from acute infections to otitis media with effusion (OME).