Role of mannose-binding lectin (MBL2) genotyping in predicting the risk of recurrent otitis media (rOM).

Otitis media (OM) is the most common childhood disease. Almost all children experience at least one episode of otitis media with effusion (OME) or acute otitis (OMA) during childhood, and a substantial subgroup is confronted with recurrent episodes. If not treated adequately, OM may lead to temporary or permanent hearing loss. It is well known that bacteria and viruses cause OMA, and may play a role in OME. Bacteria such as Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae account for about of 85% of OMA cases, with viruses making up the remaining 15%. The chronic and recurrent forms are thought to be superimposed on an underlying middle ear ventilation problem, sometimes expressed as OME. Although the complete pathophysiological picture still remains to be fully elucidated, bacteria and viruses are certainly thought to play an important role in both chronic and recurrent otitis forms. The treatment for acute otitis media is antibiotics, usually for 7 to 10 days. In the case of rOM one may elect for surgery (adenotomy or tympanotomy with placement of grommets) in order to prevent future remissions. It has been widely accepted that environmental and infectious factors trigger the development of OM in general. However, there is significant evidence from epidemiologic, anatomic, physiologic, and immunologic studies that susceptibility to recurrent episodes of OM is also partially genetically determined, although unlikely to be due to a single major gene. The specific