关键词: 慢性分泌性中耳炎, 难治性分泌性中耳炎, 危险因素, 吸烟, 鼾症, Logistic回归分析

Abstract: Objective  To analyze the clinical characteristics and risk factors of refractory secretory otitis media (rSOM) by comparing it with non-refractory secretory otitis media (nrSOM), providing a basis for early identification and intervention of rSOM. Methods  A case-control study design was used, including 102 patients with chronic secretory otitis media diagnosed and followed up regularly in the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, between January 2020 and June 2023. Patients were divided into a refractory group (49 cases) and a non-refractory group (53 cases) based on predefined refractory criteria. Demographic data, disease course, comorbidities, lifestyle, and audiological data were systematically collected. Univariate analysis and multivariate Logistic regression were used to analyze the clinical characteristics of rSOM and identify its associated risk factors.Results  The follow-up time was consistent between the two groups, and there was no statistically significant difference in age (P > 0.05). The proportion of patients with a history of snoring and smoking was significantly higher in the rSOM group than that in the nrSOM group (P < 0.05). Among patients with a history of snoring, the duration of snoring history was significantly longer in the rSOM group than that in the nrSOM group (P < 0.05). Multivariate Logistic regression analysis showed that a history of snoring (OR=3.285, 95% CI: 1.109-9.731) and a history of smoking (OR=3.771, 95% CI: 1.129-12.597) were significantly associated with rSOM (both P < 0.05) and were identified as risk factors for refractory secretory otitis media.Conclusion  A history of snoring and smoking may be important risk factors for the progression of adult chronic secretory otitis media to refractory disease. Clinical practice should strengthen the assessment of snoring-related symptoms and lifestyle factors in patients with chronic secretory otitis media in order to improve disease outcomes.

Key words: chronic otitis media with effusion, refractory secretory otitis media, risk factors, smoking, snoring, Logistic models