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  Vol. 125 No. 7, July 1999 TABLE OF CONTENTS
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Relationship of Passive Cigarette Smoking to Otitis Media

Ömer Cenker Ilicali, MD; Nesil Keles, MD; Kemal Deger, MD; Ibrahim Savas, MD

Arch Otolaryngol Head Neck Surg. 1999;125:758-762.

Objective  To determine the effect of passive smoking on otitis media with effusion (OME) and recurrent otitis media (ROM).

Design  A case-control study of children who received ventilation tubes and who were followed up for 1 year to determine the risk of developing postoperative otorrhea and early extrusion in relation to exposure to passive cigarette smoke.

Setting  Otorhinolaryngology Clinic of Istanbul School of Medicine, Istanbul, Turkey.

Patients  A total of 166 children 3 to 7 years old who required tympanostomy tubes because of OME and ROM (case group) compared with an age-matched control group of 166 children. The control group consisted of children who did not meet and never had met criteria for insertion of tympanostomy tubes.

Main Outcome Measures  Statistical analysis of factors associated with a higher prevalence of OME or ROM, postoperative otorrhea, and early tube extrusion.

Results  Passive smoking was a significant risk factor for OME and ROM. The case group was exposed to a mean of 19.6 cigarettes per day vs 14.4 cigarettes per day for the control group (P<.004). Only maternal smoking was a significant factor (P<.001); no association was found with paternal smoking. Prospective follow-up of the case group showed no significant difference in the clinical course of OME and ROM between maternally exposed and non–maternally exposed children.

Conclusions  Passive smoking increases the risk of OME and ROM in children between 3 and 7 years old. The avoidance of daily exposure to domestic tobacco smoke could have a public health impact.


From the Department of Otorhinolaryngology, Istanbul Faculty of Medicine, Istanbul, Turkey.



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