The association between allergic rhinitis and otitis media: A national representative sample of in South Korean children

Although many studies have reported that allergic rhinitis is an independent risk factor highly related to otitis media in children, there is still lack of epidemiological studies on demographics. The objective of this study was to identify if allergic rhinitis was an independent risk factor for otitis media in children aged between 7 and 12 years by using the nationwide survey data representing the local population of South Korea. This is a secondary study based on the ENT examination data (eg. acute otitis media, otitis media with effusion, chronic otitis media). The subjects of this study were 472 children (248 male and 224 female) who completed the Korea National Health and Nutrition Examination Survey 2015. The presence of otitis media was examined by otolaryngologists using tympanometric measurements, audiometric measurements, and otoscopic examination. Allergic rhinitis was diagnosed by Koreanversion of International Study of Asthma and Allergies in Childhood, a total serum immunoglobulin E test, an allergen-specific immunoglobulin E test, a blood eosinophil test, an eosinophil cationic protein test, a nasal cytology for eosinophils test, a skin reaction test, and an antigen simultaneous test. Confounding factors included age, gender, the levels of income for households, and household composition. The relationship between allergic rhinitis and otitis media was analyzed by a complex sample logistic regression analysis and the odds ratio and 95% confidence interval were presented. The results of a complex sample design logistic regression revealed that allergic rhinitis in children was significantly associated with otitis media (p < 0.05). Even after adjusting all confounding factors, children with allergic rhinitis had twice significantly higher risk of otitis (OR = 2.04; 95% CI: 1.30-3.18) than children without allergic rhinitis. This epidemiologic study confirmed the independent relationship between pediatric allergic rhinitis and otitis media. In the future, longitudinal study will be needed to verify causality of allergic rhinitis and otitis media.