Familial link of otitis media requiring tympanostomy tubes.
OBJECTIVES/HYPOTHESIS
Placement of tympanostomy tubes for recurrent or chronic otitis media is the most commonly performed ambulatory procedure in the United States. Etiologies have been speculated to be environmentally based, and studies have suggested a genetic component to the disease. However, no large-scale studies have attempted to define a familial component. The objective of this study was to determine the familial risk of otitis media requiring tympanostomy tubes (OMwTT) in a statewide population.


STUDY DESIGN
Retrospective observational cohort study with population-based matched controls.


METHODS
Using an extensive genealogical database linked to medical records, the familial risk of OMwTT was calculated for relatives of probands (46,249 patients diagnosed with OMwTT from 1996-2013) compared to random population controls matched 5:1 on sex and birth year from logistic regression models.


RESULTS
The median age at time of tympanostomy tube placement was 1 year (interquartile range, 0-2 years). First-degree relatives of patients with OMwTT, primarily siblings, had a 5-fold increased risk of OMwTT (P < 10-16 ). Second-degree relatives were at a 1.5-fold increased risk (P < 10-15 ). More extended relatives (third, fourth and fifth degree) showed a 1.4-fold increased risk (P < 10-15 ).


CONCLUSIONS
In the largest population-based study to date, a significant familial risk is confirmed in OMwTT, suggesting otitis media may have a significant genetic component given the increased risk found in close as well as distant relatives. This could be influenced by shared environments given a five-times risk observed in siblings. Further understanding the genetic basis of OMwTT and its interplay with environmental factors may clarify the etiology and lead to better detection of disease and treatments.


LEVEL OF EVIDENCE
3b. Laryngoscope, 127:962-966, 2017.
['Padia|Reema|R|', 'Alt|Jeremiah A|JA|', 'Curtin|Karen|K|', 'Muntz|Harlan R|HR|', 'Orlandi|Richard R|RR|', 'Berger|Justin|J|', 'Meier|Jeremy D|JD|']
D000293:Adolescent D000328:Adult D000367:Age Factors D016022:Case-Control Studies D002648:Child D002675:Child, Preschool D016208:Databases, Factual D005260:Female D005500:Follow-Up Studies D020022:Genetic Predisposition to Disease D006801:Humans D007223:Infant D016015:Logistic Models D008297:Male D008875:Middle Aged D008876:Middle Ear Ventilation D010033:Otitis Media D010375:Pedigree D012189:Retrospective Studies D018570:Risk Assessment D012737:Sex Factors D016896:Treatment Outcome D055815:Young Adult
Otitis media tympanostomy tubes genetics pedigree