Increased Incidence of Surgical Intervention for Otitis Media With Effusion Among Patients With Type 2 Inflammatory Diseases

Yen-Che Wang; You-Cheng Yu; Shih-Huan Chen; Jen-Chih Lee; Tang-Chuan Wang; Heng-Jun Lin; Cheng-Li Lin; Chun-Hsu Yao; Tzu-Liang Chen; Fuu-Jen Tsai; Der-Yang Cho; Richard S Tyler

doi:10.1016/j.jaip.2024.12.014

Increased Incidence of Surgical Intervention for Otitis Media With Effusion Among Patients With Type 2 Inflammatory Diseases

J Allergy Clin Immunol Pract. 2025 Jan 14:S2213-2198(24)01256-X. doi: 10.1016/j.jaip.2024.12.014. Online ahead of print.

Authors

Yen-Che Wang¹, You-Cheng Yu², Shih-Huan Chen¹, Jen-Chih Lee³, Tang-Chuan Wang⁴, Heng-Jun Lin⁵, Cheng-Li Lin⁵, Chun-Hsu Yao⁶, Tzu-Liang Chen⁷, Fuu-Jen Tsai⁸, Der-Yang Cho⁹, Richard S Tyler¹⁰

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan.
² The Ph.D. Program for Medical Engineering and Rehabilitation Science, College of Biomedical Engineering, China Medical University, Taichung, Taiwan.
³ Department of Pulmonary and Critical Care Medicine, China Medical University Hsinchu Hospital, Hsinchu, Taiwan.
⁴ Department of Otolaryngology-Head and Neck Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Master Program for Biomedical Engineering, College of Biomedical Engineering, China Medical University, Taichung, Taiwan. Electronic address: [email protected].
⁵ Management Office for Health Data (DryLab), Clinical Trial Center (CTC), China Medical University Hospital, Taichung, Taiwan.
⁶ Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan.
⁷ School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
⁸ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
⁹ Translational Cell Therapy Center, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa.

PMID: 39808094
DOI: 10.1016/j.jaip.2024.12.014

Abstract

Background: Otitis media with effusion (OME) is associated with comorbidities such as allergic rhinitis, gastroesophageal reflux disease, asthma, and more. Many of these comorbidities can be caused by type 2 inflammation (T2I). This study aims to determine the risk of undergoing OME surgery in patients with and without T2I disease.

Objective: To determine whether T2I disease is associated with an increased incidence of OME surgery.

Methods: This retrospective, matched-cohort study involved the retrospective recruitment of patients with T2I disease (n = 31,603) and non-T2I disease (n = 31,603) from 2010 to 2019, using the Taiwan National Health Insurance Research Database. Statistical analyses were performed using t tests, Cox proportional regression models, Kaplan-Meier estimators, and log-rank tests.

Results: Among patients with OME, those with T2I disease had a greater risk of undergoing OME surgery, with an adjusted hazard ratio of 9.84 (95% confidence interval [CI], 8.90-10.88), than those without T2I disease. The adjusted relative risk for the number of OME surgeries in patients with T2I disease was 11.14 (95% CI, 10.30-12.05). Kaplan-Meier analysis showed consistently higher cumulative incidence curves in patients with T2I disease throughout the follow-up period (log-rank test: P < .001).

Conclusions: OME patients with T2I disease had a significantly higher incidence of undergoing surgery due to failed conservative treatment, indicating that T2I may play an important role in middle ear disorders. Further research on this topic should be considered significant and worthy of investigation.

Keywords: Allergic rhinitis; Asthma; Atopic dermatitis; Chronic rhinosinusitis with nasal polyposis; Comorbidities; Otitis media with effusion; Type 2 inflammation.