https://doi.org/10.1177/0003489420903336
Annals of Otology, Rhinology & Laryngology
1–7
© The Author(s) 2020
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DOI: 10.1177/0003489420903336
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Article
Introduction
Otitis media (OM) is a common pediatric infectious dis-
ease. In a study from 2005, it was estimated that it affects
over 700 million people worldwide each year, most of them
are children.
1
In the same year, some 39.43 and 30.02 dis-
ability-adjusted life years per 1 00 000 people were attrib-
uted to OM in highly- and very highly-developed countries,
respectively.
2
More than 80% of children would experience at least one
acute otitis media (AOM) episode until their 3rd birthday,
and 10% to 15% of them would develop persistent serous
otitis media (SOM) or recurrent acute otitis media (rAOM)
episodes. These conditions are associated with hearing loss,
learning disabilities, the need for multiple antibiotic treat-
ments, impaired linguistic development and a reduced qual-
ity of life.
3-5
To date, the definitive treatment for rAOM and
persistent SOM associated with hearing loss is ventilating
tube insertion (VTI),
6
which is the most frequent surgical
procedure performed in U.S. children, with 6 99 000 cases
in 2010 alone.
7
Pediatric obesity is also a major public health concern.
The overall prevalence of obesity among U.S. youth was
18.5% in 2015 to 2016; among school-aged children, 6 to
11 years of age, it was 18.4%, and among adolescents, 12
to 19 years of age, it was as high as 20.6%.
8
In many other
industrialized and non-industrialized countries, pediatric
obesity prevalence is also increasing.
9,10
Childhood
903336AOR XX X 10.1177/0003489420903336Annals of Otology, Rhinology & LaryngologyKlein et al
research-article 2020
1
Department of Otolaryngology—Head and Neck Surgery, Faculty of
Health Sciences, Samson Assuta Ashdod University Hospital, Ben Gurion
University, Ashdod, Israel
Corresponding Author:
Tal Marom, MD, Department of Otolaryngology—Head and Neck
Surgery, Faculty of Health Sciences, Samson Assuta Ashdod University
Hospital, Ben Gurion University, 7 Ha’Refua Street, Ashdod, 7747629,
Israel.
Emails: talmaro@assuta.co.il; talmarom73@gmail.com
Are Children Scheduled for Ventilation
Tubes Insertion Overweight?
A Cohort of Israeli Children
Ayala Klein, MD
1
, Oded Kraus, MD
1
, Alisa Luria, MD
1
,
Sharon Ovnat Tamir, MD
1
, and Tal Marom, MD
1
Abstract
Objective: To study the hypothesis that children scheduled for ventilation tube insertion (VTI), a surrogate procedure
reflecting otitis media (OM) presence, are overweight or obese.
Patients and Methods: Charts of Israeli children aged 0 to 9 years undergoing VTI with or without adenoidectomy
between 9/1/17 and 3/31/19 in a secondary level hospital were retrospectively identified. We compared their mean body
mass index (BMI, kg/m
2
) to the mean BMI of a control group comprised of children who underwent surgeries unrelated
to OM (fracture fixation/reduction, inguinal/umbilical hernia repair, meatotomy, appendectomy). BMI measurements were
plotted on gender- and age-matched curves to determine BMI percentile, and were also compared to the national pediatric
overweight/obesity data. Normal weight was defined as BMI percentile <85%, overweight was BMI percentile between
85% and 97%, and obesity was BMI percentile >97%.
Results: The VTI group included 83 children (mean age: 3.5 ± 1.8 years). The control group included 77 children (mean
age: 6.3 ± 1.9 years). No statistically significant difference was found in the mean BMI values between both groups (P = .22).
When compared to age- and gender-adjusted 50th BMI percentile of the general pediatric population, the mean BMI of
the VTI group was significantly higher: for boys, 16.9 versus 15.2 (P < .01), and for girls, 16.6 versus 15.3 (P = .03), but not
in the control group: P = .16 (boys) and P = .11 (girls).
Conclusion: Children undergoing VTI were overweight when compared to their age- and gender-matched peers. This
observation was more noticeable in boys.
Keywords
otitis media, pediatric obesity, overweight, ventilating tube insertion, body mass index