The genetic component of middle ear disease in the first 5 years of life

Arch Otolaryngol Head Neck Surg. 2004 Mar;130(3):273-8. doi: 10.1001/archotol.130.3.273.


Objective: To determine the genetic component of time with middle ear effusion (MEE) and episodes of MEE and acute otitis media.

Design: Prospective twin/triplet cohort.

Setting: Research center at a tertiary pediatric hospital.

Participants: A total of 168 healthy same-sex twin and 7 same-sex triplet sets were recruited by age 2 months.

Interventions: Longitudinal assessment of middle ear status by pneumatic otoscopy and tympanometry at monthly evaluations, and at examinations during upper respiratory tract infections or symptoms of middle ear disease.

Outcome measures: Proportion of time with MEE and episodes of acute otitis media and MEE.

Results: Of the 140 sets for which zygosity was obtained, 114 were followed up to age 3 years and 83 sets to age 5 years. The heritability estimate for proportion of time with MEE in the first 5 years of life was 0.72 (P<.001). The correlation of proportion of time with MEE between children within a set was significantly higher in monozygotic sets (0.65-0.77) than in dizygotic sets (0.31-0.39) for each year to age 3 years. In the fourth and fifth years of life, the correlations decreased in both monozygotic and dizygotic twin sets.

Conclusions: Findings for the first 2 years of follow-up have been previously published and indicate a strong genetic component to the proportion of time with MEE. In the present report, which details the entire 5-year follow-up, the effect of this component appears to attenuate after the third year but its cumulative effect remains significant after 5 years.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Twin Study

MeSH terms

  • Acoustic Impedance Tests
  • Acute Disease
  • Child, Preschool
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Otitis Media / genetics*
  • Otitis Media with Effusion / genetics*
  • Otoscopy
  • Prospective Studies
  • Time Factors
  • Triplets
  • Twins
  • Twins, Dizygotic
  • Twins, Monozygotic