Changes in calbindin expression within the flocculus after unilateral labyrinthectomy in rats.

The role of flocculus in vestibular compensation is still a controversial issue. Calbindin regulates intracellular signaling and has been reported to be a reliable marker of Purkinje cell. Expression of calbindin in flocculus was examined using immunohistochemistry following unilateral labyrinthectomy (UL) in rats. Both the staining intensity and number of calbindin-positive Purkinje cells in the ipsilateral flocculus to the lesion side decreased 6h after UL compared to the control and contralateral side. Forty-eight hours after UL, the expression of calbindin returned to control levels and asymmetric expression in bilateral flocculus subsided. These transient reduction of calbindin expression in the ipsilateral flocculus may reflect a decrease in the GABAergic inhibition of the floccular Purkinje cell to the ipsilateral vestibular nuclei during vestibular compensation.

Hearing threshold of Korean adolescents associated with the use of personal music players.

PURPOSE: Hearing loss can lead to a number of disabilities and can reduce quality of life. Noise-induced hearing losses have become more common among adolescents due to increased exposure to personal music players. We, therefore, investigated the use of personal music player among Korean adolescents and the relationship between hearing threshold and usage pattern of portable music players. MATERIALS AND METHODS: A total of 490 adolescents were interviewed personally regarding their use of portable music players, including the time and type of player and the type of headphone used. Pure tone audiometry was performed in each subject. RESULTS: Of the 490 subjects, 462 (94.3%) used personal music players and most of them have used the personal music player for 1-3 hours per day during 1-3 years. The most common type of portable music player was the MP3 player, and the most common type of headphone was the earphone (insert type). Significant elevations of hearing threshold were observed in males, in adolescents who had used portable music players for over 5 years, for those over 15 years in cumulative period and in those who had used earphones. CONCLUSION: Portable music players can have a deleterious effect on hearing threshold in adolescents. To preserve hearing, adolescents should avoid using portable music players for long periods of time and should avoid using earphones.

Pseudocolor transformation for visualization of ossicles in CT images.

CONCLUSION: Pseudocolor transformation demonstrated partial efficiency for increasing the visibility of the stapes and the incudostapedial (IS) joint in CT images. Variable color transformation could be examined in the future for increasing detection of otologic lesions. OBJECTIVES: Pseudocolor transformation is a technique for artificially assigning colors to a gray scale. This study was undertaken to evaluate the efficiency of the pseudocolor transformation technique for the visualization of ossicles in temporal bone CT images. SUBJECTS AND METHODS: Twenty CT studies of healthy ears were reviewed. CT images were transformed to pseudocolor (rainbow scale) with Image-Pro Plus 4.0. software and compared with plain images using the following rating scale. For each image one of five scores concerning the visibility of the stapes and IS joint was given: 1, not seen; 2, probably not seen; 3, not sure; 4, probably seen; 5, definitely seen. Visualization sensitivity was determined through statistical analysis using a paired t test. RESULTS: The stapes and IS joint were more easily identifiable in pseudocolor-transformed images compared with plain images (p<0.05). The oval window and footplate were both more easily distinguishable in pseudocolor-transformed images compared with plain images (p<0.05).

Clinical analysis of hearing levels in vitiligo patients.

Vitiligo is a common, often inherited disorder resulting from a loss of functional melanocytes. The mechanism by which skin melanocytes disappear can also affect other melanocytic organs. Although melanocyte-associated diseases have racial differences, there have been no studies of hearing loss associated with vitiligo in Asian populations, and no analysis of any relationship between hearing loss and severity of vitiligo. So we tried to assess the hearing differences between Korean vitiligo patients and normal subjects. Pure tone audiometry, auditory brainstem response, and electrocochleography results from 89 vitiligo patients, 47 with active disease and 42 with stable disease, and 89 healthy subjects, were compared. Pure tone thresholds in both vitiligo subgroups were significantly lower than in the control group at 1,000, 4,000, 6,000 and 8,000 Hz (p < 0.05). Pure tone thresholds in the active disease group were significantly lower than in the stable disease group at 1,000, 2,000, 4,000, 6,000 and 8,000 Hz (p < 0.05). Vitiligo patients had a significant decrease in peak I latency and significant increases in peak III and interpeak I-III latencies compared with controls. Compared with the stable disease group, the active disease group had a significant decrease in peak I latency and significant increases in interpeak I-III and interpeak I-V latencies (p < 0.05). Electrocochleography showed that vitiligo patients had significant increases in summation potential (SP) amplitude, action potential (AP) amplitude in the left ear, and SP/AP ratios in both ears, compared with controls (p < 0.05). In conclusion Korean patients with vitiligo show hearing loss compared with controls, which may be caused by functional disorders of intermediate cells (melanocytes) of the stria vascularis.

Saccular damage in patients with idiopathic sudden sensorineural hearing loss without vertigo.

OBJECTIVE: Saccule could be damaged in patients with idiopathic sudden sensorineural hearing loss (ISSHL) with vertigo and with high-frequency sensorineural hearing loss. Thus, the saccule might be deteriorated subclinically in ISSHL cases without vertigo. Therefore, we investigated saccular damage in ISSHL patients without vertigo through vestibular evoked myogenic potentials (VEMP). STUDY DESIGN: A prospective study. SUBJECTS AND METHODS: Fifty-two patients with ISSHL without vertigo were enrolled in the study. We identified VEMP in patients with ISSHL and analyzed the association of VEMP with initial hearing threshold, each threshold according to frequency, the type of audiogram, and hearing recovery. RESULTS: For cases with absent VEMP, we found significant differences between patients with 90 dB or more hearing loss and those with a hearing loss less than 55 dB with frequencies over 1000 Hz. Patients with profound hearing loss presented significantly high abnormal and absent VEMP than patients with audiograms of other types. CONCLUSION: These findings suggest that the subclinical deterioration of the saccular neuroepithelium is associated with patients with ISSHL having profound hearing loss at the high frequency.

Comparison of facial nerve paralysis in adults and children.

PURPOSE: Facial nerve injury can occur in the regions ranging from the cerebral cortex to the motor end plate in the face, and from many causes including trauma, viral infection, and idiopathic factors. Facial nerve paralysis in children, however, may differ from that in adults. We, therefore, evaluated its etiology and recovery rate in children and adults. MATERIALS AND METHODS: We retrospectively evaluated the records of 975 patients, ranging in age from 0 to 88 years, who displayed facial palsy at Kyung Hee Medical Center between January 1986 and July 2005. RESULTS: The most frequent causes of facial palsy in adults were Bell's palsy (54.9%), infection (26.8%), trauma (5.9%), iatrogenic (2.0%), and tumors (1.8%), whereas the most frequent causes of facial palsy in children were Bell's palsy (66.2%), infection (14.6%), trauma (13.4%), birth trauma (3.2%), and leukemia (1.3%). Recovery rates in adults were 91.4% for Bell's palsy, 89.0% for infection, and 64.3% for trauma, whereas recovery rates in children were 93.1% for Bell's palsy, 90.9% for infection, and 42.9% for trauma. CONCLUSION: These results show that causes of facial palsy are similar in adults and children, and recovery rates in adults and children are not significantly different.

Effect of nitric oxide on auditory cortical neurons of aged rats.

Age-related changes in the effects of nitric oxide (NO) on neurons of the auditory cortex have not been determined. We therefore evaluated the anatomical changes and neurophysiological characteristics of these neurons in rats as a function of age. The numbers of cresyl violet stained cells, the numbers and areas of NADPH-d-positive neuronal cell bodies, and their optical density, were measured in Sprague-Dawley rats aged 24 months (aged group) and 4 months (control group). The modulatory effects of NO on K(+) currents of acutely isolated rat auditory cortical neurons were also assessed. There were no between-group differences in the distribution patterns of glial cells and neurons, or in the numbers and areas of NADPH-d-positive neuronal cell bodies. However, the optical density of NADPH-d-positive neuronal cell bodies was significantly greater in the aged group than in the control group. In addition, voltage-gated K(+) currents of rat auditory cortical neurons were activated by increased levels of NO. As activation of the K(+) current likely suppresses neuronal excitability, age-associated increases in NO production can hinder the function of the acoustic center by inhibiting neuron excitability.

Subjective visual vertical during eccentric rotation in patients with benign paroxysmal positional vertigo.

OBJECTIVE: There have been only a few reports of subjective visual vertical (SVV) in patients with benign paroxysmal positional vertigo (BPPV), and each showed slightly different results. SVV measurement during eccentric rotation that stimulated only 1 labyrinth was known to show a considerable improvement in comparison with conventional SVV as a clinical measure of otolith function. But there has not been a report regarding SVV during eccentric rotation in patients with BPPV. We therefore measured SVV during eccentric rotation and investigated the function of utricles in patients with BPPV. STUDY DESIGN: Retrospective study. SETTING: Tertiary referral center. PATIENTS: Twenty-three patients with BPPV. INTERVENTION: Diagnostic procedure. MAIN OUTCOME MEASURES: SVV was measured in 23 patients with BPPV and 20 normal subjects. We compared the SVV values before and during eccentric rotation toward the right and left in both patients with BPPV and the control group. RESULTS: Between BPPV patients and the control group, no difference in the SVV value was observed in pre-eccentric rotation, but significant differences of SVV values were found during eccentric rotation. CONCLUSION: We identified utricular dysfunction in patients with BPPV during eccentric rotation and suggested that eccentric rotation might be a good method to measure utricular dysfunction.

Effect of paranasal sinusitis on the development of otitis media with effusion: influence of eustachian tube function and adenoid immunity.

OBJECTIVES: Concordance between sinusitis and otitis media with effusion (OME) has been reported in 5-60% of patients. Since nasal diseases induce edema and lymphoid tissue hyperplasia in the nasopharyngeal mucosa, especially the adenoids, chronic infection of the adenoids has been reported to induce otitis media. In addition, deterioration in the mucosal barrier of the adenoids makes the latter vulnerable to bacterial infections, resulting in OME or sinusitis. We therefore evaluated adenoid local immunity and Eustachian tube function by sinusitis and the concordance between sinusitis and OME. MATERIALS AND METHODS: We examined PNS series and tympanometry of 520 patients who had undergone adenotonsillectomies. In addition, local adenoidal immunity was evaluated in 10 children with OME and sinusitis, 11 with only sinusitis, 10 with only OME and 12 with no history of OME or sinusitis. Adenoid size, squamous metaplasia, IgA, BCL-6, and mucosal barrier were also determined. RESULTS: Of 520 patients, 80 (15.4%) had both OME and sinusitis. The incidence of Eustachian tube dysfunction differed significantly between patients with and without sinusitis (p=0.03). The incidence of squamous metaplasia differed significantly between patients with sinusitis plus OME and patients with sinusitis alone (p=0.01), and between patients with OME alone and those without both conditions (p=0.005). Patients with both sinusitis and OME differed significantly in IgA secretion (p=0.01) and Bcl-6 expression (p=0.02) from those with sinusitis alone, as did patients with OME alone and those without both conditions (p=0.02 and p=0.03, respectively). CONCLUSIONS: Sinusitis plus OME were present in 15.4% of patients. Eustachian tube dysfunction was present in 37.9% of sinusitis patients and in 28.4% of those without sinusitis. IgA, BCL-6 and squamous metaplasia were important in local adenoidal immunity.

The results of vestibular evoked myogenic potentials, with consideration of age-related changes, in vestibular neuritis, benign paroxysmal positional vertigo, and Meniere's disease.

CONCLUSION: We interpreted VEMP findings in patients with the three major peripheral vertigo diseases, taking age-related changes into consideration. We found different abnormal VEMP rates among the three diseases, as well as differences in the proportion of parameters that were abnormal, according to the type of disease. OBJECTIVES: Vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease, common diseases that cause peripheral vertigo, often affect the saccule or inferior vestibular nerve, which are pathways of vestibular evoked myogenic potential (VEMP). Also, aging could have a primary effect on diminished VEMP responses. Our study investigated VEMP the findings in patients with the diseases in relation to their age. PATIENTS AND METHODS: A total of 134 patients with vestibular neuritis, 62 with BPPV, and 29 with Meniere's disease were enrolled in this study. The VEMP findings in patients within the three disease groups were interpreted using our own normative ranges according to age. RESULTS: Abnormal VEMP rates in the vestibular neuritis, BPPV, and Meniere's disease groups were 36.6%, 25.8%, and 69%, respectively. The proportion of prolonged p13 latency in BPPV patients with abnormal VEMP responses was relatively high compared with the other two diseases. VEMP asymmetry in the patients with Meniere's disease was relatively high.

Acyclovir plus steroid vs steroid alone in the treatment of Bell's palsy.

PURPOSE: The pathogenetic mechanism of Bell's palsy is thought to involve herpes simplex virus reactivation within the geniculate ganglion, followed by inflammation and entrapment of the nerve at the meatal foramen. We therefore compared the therapeutic effect of acyclovir plus steroid vs steroid alone, in combination with physical therapy, in patients with Bell's palsy. MATERIALS AND METHODS: In a double-blind, randomized, prospective trial, 91 patients were randomized to treatment with acyclovir and prednisone (44 patients) or prednisone alone (47 patients). All patients underwent physical therapy. The follow-up period was greater than 6 months or encompassed the period of complete recovery from paralysis. House-Brackmann grade was evaluated 2 and 6 months after onset, with complete and satisfactory recovery defined as House-Brackmann grades I and II, respectively. RESULTS: The overall recovery rate of patients treated with steroid and acyclovir (93.1%) was greater than that of patients treated with steroid alone (85.1%), but the difference was not statistically significant. CONCLUSION: The benefit of acyclovir in Bell's palsy has not been definitively established.

Vestibular evoked myogenic potentials in patients with benign paroxysmal positional vertigo involving each semicircular canal.

PURPOSE: We have investigated vestibular evoked myogenic potentials (VEMPs) as a function of age and the involvement of each of the 3 semicircular canals in patients with benign paroxysmal positional vertigo (BPPV). MATERIALS AND METHODS: We performed prospective assessment from January 2005 to September 2006. Vestibular evoked myogenic potential was measured in 53 patients with BPPV and 84 healthy subjects, with the latter subdivided by patient age. RESULTS: The subgroup of healthy subjects older than 60 years showed significantly more prolonged p13 and n23 latencies and lower amplitude than the other 2 subgroups. Of the 53 patients with BPPV, 13 (24.5%) showed abnormal VEMP responses on the affected side when compared with their age-related control subgroup. There was no correlation between VEMP findings and the affected semicircular canal. CONCLUSION: Patients with BPPV may show abnormal VEMP findings, irrespective of the involved semicircular canal, and age was associated with VEMP results suggesting degeneration of the maculae of the saccule.

Relationship between effusion bacteria and concentrations of immunoglobulin in serum and effusion fluid in otitis media with effusion patients.

OBJECTIVE: Bacterial infection and immunity are important in the development of otitis media with effusion (OME) in children who have not developed Eustachian tube function. We evaluated the relationship between the presence of bacteria in effusion fluid and immunoglobulin (Ig) concentrations in effusion fluid and serum. METHODS: Middle ear effusion and blood samples were collected from 58 OME patients who had undergone ventilation tube insertion. Bacteria in effusion fluid were detected by standard bacterial culture and polymerase chain reaction (PCR). Serum and middle ear fluid Ig concentrations in OME patients and serum Ig concentrations in 64 control children were evaluated. RESULTS: Bacteria were detected in 24/58 (41.4%) effusion fluid samples by PCR and in 12/58 (20.6%) by standard culture. There was no correlation between effusion Ig concentration and the presence of bacteria or between serum and effusion Ig concentrations, but serum Ig concentration was related to the presence of effusion bacteria (p<0.05). Serum IgG, IgA and IgM in patients with OME were lower than in control patients (p<0.05). CONCLUSIONS: These results suggest that the presence of effusion bacteria in OME may be related to systemic immunity, but that the concentration of Ig in effusion fluid may not be affected by the presence of effusion bacteria.

Toll-like receptors 2 and 4 and their mutations in patients with otitis media and middle ear effusion.

OBJECTIVES: Toll-like receptors (TLRs) detect microbial infections and they can directly induce innate host defense responses. TLR 2 has been shown to be primarily involved in the recognition of peptidoglycans and lipoteichoic acid of gram positive bacteria. TLR 4 recognizes lipopolysaccharides and lipoteichoic acids from both gram-negative and gram-positive bacteria. Both mutations lead a reduced capacity to elicit inflammation and they increase the risk for gram-positive and negative infections. This study was performed to investigate the expressions of TLR 2 and 4 and their mutations in patients suffering with otitis media and middle ear effusion. METHODS: Middle ear fluid samples were collected from 40 otitis media effusion (OME) patients who had ventilating tubes inserted. Bacteria in the effusion fluid were detected by standard bacterial culture. The secreted IgG, IgA and IgM were measured by Enzyme-linked immunosorbent assay. TLR 2 and 4 were assessed by performing RT-PCR. The genomic DNA from each patient was isolated from the middle ear fluid samples that were collected from 60 OME patients, and the presence of mutations was determined by performing restriction digestion and DNA sequencing analysis. RESULTS: Among the 40 middle ear fluid samples, bacteria were detected in 13 middle ear fluid samples. The amounts of IgM, IgA, and IgG were 151.20+/-60.94 ng/mL, 21.59+/-7.96 ng/mL and 11.55+/-16.98 ng/mL, respectively. TLR 2 and 4 were expressed in the middle ear fluid and the expression of TLR 2 was higher than that of TLR 4. However, there was no correlation between the expressions of TLR 2 and 4, and the concentration of immunoglobulin or the presence of bacteria (P>0.05). There ware no mutations of TLR 2 (Arg753Gln, Arg677Trp) and TLR 4 (Asp299Gly, Thr399Ile). CONCLUSION: TLR 2 and 4 were expressed in all the middle ear fluid samples of OME, but the mutations of TLR 2 and 4 were not detected. TLR 2 and 4 may play a vital role in the immunological responses of patients with OME.

Temporal Changes of the Calcium-binding Proteins in the Medial Vestibular Nucleus following Unilateral Labyrinthectomy in Rats.

Calcium (Ca(2+)) is an intracellular second messenger associated with neuronal plasticity of the central nervous system. The calcium-binding proteins regulate the Ca(2+)-mediated signals in the cytoplasm and buffer the calcium concentration. This study examined temporal changes of three calcium-binding proteins (calretinin, calbindin and parvalbumin) in the medial vestibular nucleus (MVN) during vestibular compensation after unilateral labyrinthectomy (UL) in rats. Rats underwent UL, and the changes in the expression of these proteins at 2, 6, 12, 24, 48, and 72 h were examined by immunofluorescence staining. The expression levels of all three proteins increased immediately after UL and returned to the control level by 48 h. However, the level of calretinin showed changes different from the other two proteins, being expressed at significantly higher level in the contralateral MVN than in the ipsilateral MVN 2 h after UL, whereas the other two proteins showed similar expression levels in both the ipsilateral and contralateral MVN. These results suggest that the calcium binding proteins have some protective activity against the increased Ca(2+) levels in the MVN. In particular, calretinin might be more responsive to neuronal activity than calbindin or parvalbumin.

Age-related differences in parameters of vestibular evoked myogenic potentials.

CONCLUSIONS: The statistically significant correlations between vestibular evoked myogenic potential (VEMP) parameters and age may be due to hair cell loss of the otolith organ and/or to degenerative changes of the vestibular neural pathway. These findings indicate that age should be taken into account when interpreting VEMP results. It is also important to determine a standard method for performing VEMP and a universal index for comparison among laboratories. OBJECTIVES: VEMP, which measures the surface electric potential from the cervical muscle evoked by sufficiently loud sounds, is a useful tool to evaluate vestibule-colic reflex function. We have assayed the effect of age on VEMP results. SUBJECTS AND METHODS: After excluding subjects with a previous history of dizziness, middle ear pathology, or other inner ear symptoms, a total of 97 healthy volunteers (194 ears) were included. All VEMP parameters were analyzed to find differences related to side and gender, as well as the relationship between age and each VEMP parameter. RESULTS: Age was correlated with all VEMP parameters. Latency of p13, n23 showed a negative correlation and amplitude of p13-n23 showed a positive correlation with age. Differences between the right and left sides were not significant.

Bacteriology of chronic suppurative otitis media--a multicenter study.

CONCLUSIONS: Bacterial predominance and antibiotic sensitivity have changed over time, making continuous and periodic surveillance necessary in guiding appropriate antibacterial therapy. OBJECTIVES: With the development and widespread use of antibiotics, the types of pathogenic microorganisms and their resistance to antibiotics have changed. Knowledge of the species and resistance rates of current pathogens is important for determining the appropriate antibiotics for patients with chronic suppurative otitis media. We investigated the current bacteriology of chronic suppurative otitis media. SUBJECTS AND METHODS: This was a retrospective study of 1102 patients with chronic suppurative otitis media seen at six hospitals in Korea from January 2001 to December 2005. RESULTS: The most commonly identified pathogenic bacterial species was Pseudomonas, with the next most prevalent being methicillin-resistant Staphylococcus aureus (MRSA).

Squamous metaplasia and BCL-6 in pediatric adenoid accompanied by otitis media with effusion.

PURPOSE: Deterioration of local immunity in the adenoids may make them vulnerable to infection by microorganisms, resulting in otitis media with effusion. To determine the factors associated with this condition, we evaluated adenoid size, mucosal barrier, squamous changes of ciliated epithelium, IgA secretion, and BCL-6 expression in adenoids. MATERIALS AND METHODS: Seventeen children diagnosed with otitis media with effusion (OME group) and 20 children without any history of OME (control group) were enrolled. Their adenoids were sized by lateral view X-ray and stained with hematoxylin and eosin to detect squamous metaplasia. The adenoids were also stained with cytokeratin to evaluate mucosal barriers, and with anti- IgA antibody and anti- BCL-6 antibody to determine expression of IgA and BCL-6. RESULTS: The OME group showed greater incidence of squamous metaplasia, fewer ciliated cells, and lower expression of BCL-6 (p < 0.05 each). Deterioration of the mucosal barrier was detected in the OME group (p > 0.05). IgA secretion and adenoid size were the same for the OME and the control groups. CONCLUSION: These results suggest that increased squamous metaplasia and lower BCL-6 expression in adenoids may be associated with increased susceptibility to OME.

The role of allergic rhinitis in the development of otitis media with effusion: effect on eustachian tube function.

PURPOSE: The pathogenesis of otitis media with effusion (OME) is considered multifactorial, with viral upper respiratory tract infection and eustachian tube dysfunction. Allergy may be related to the pathogenesis of OME or to another etiological factor. We investigated the role of allergic rhinitis (AR) in children with OME and evaluated eustachian tube function in patients with AR. MATERIALS AND METHODS: We prospectively analyzed the prevalence of AR, serum eosinophil count, and serum total IgE concentrations in 123 children with OME and in 141 controls. IgE concentration in middle ear effusion was compared in children with OME with and without AR, and eustachian tube function after a nasal provocation test was compared between patients with AR and controls. RESULTS: The prevalence of AR in children with OME (28.4%) and control subjects (24.1%) did not differ significantly. These 2 groups also showed no differences in total eosinophil count and serum and middle ear effusion IgE concentration. Abnormalities in eustachian tube function were the same in patients with AR and controls. CONCLUSIONS: Allergic rhinitis may not be related to the development of OME in children.

Relationship between pediatric obesity and otitis media with effusion.

OBJECTIVE: To investigate the relationship between pediatric otitis media with effusion and obesity, as determined by body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and serum triglyceride (TG) and total cholesterol (TC) concentrations. DESIGN: A prospective, nonrandomized, case-control study. SETTING: University-affiliated hospital. SUBJECTS: The experimental group comprised 155 children aged 2 to 7 years, who received unilateral or bilateral ventilation tube insertion for the treatment of otitis media with effusion. The control group comprised 118 children with no history of otitis media with effusion, who underwent operations for conditions other than ear diseases. Based on BMI and serum TG and TC concentrations, we divided the experimental group into 2 subgroups, those who were and were not obese. MAIN OUTCOME MEASURES: We determined the difference between the experimental and control groups in BMI and serum TG and TC concentrations and the difference between the obese and nonobese subgroups in frequency of ventilation tube insertion. RESULTS: Mean +/- SD BMI (22.0 +/- 3.4 vs 16.3 +/- 2.4) (P = .01) and mean +/- SD TC level (195.0 +/- 31.0 mg/dL vs 159.3 +/- 26.9 mg/dL [5.05 +/- 0.80 mmol/L vs 4.13 +/- 0.70 mmol/L]) (P = .04), but not mean serum TG level (109.4 +/- 40.4 mg/dL vs 90.0 +/- 52.3 mg/dL [1.24 +/- 0.46 mmol/L vs 1.02 +/- 0.59 mmol/L]) (P = .13), were significantly higher in the experimental group than in the control group. Frequency of ventilation tube insertion, however, did not differ significantly between the obese and nonobese subgroups, whether divided by BMI (P = .10) or serum TG (P = .12) or TC (P = .07) concentration. CONCLUSION: Childhood obesity may be associated with the occurrence of otitis media with effusion.