Which patient is NOT at increased risk for developing otitis media?

Which patient is NOT at increased risk for developing otitis media?

• A. 3-year-old with IgA deficiency
• B. 15-month-old with Down syndrome
• C. 9-month-old with lactose intolerance
• D. 2-year-old with cleft palate repair

Answer: (C)

Young children are especially prone to otitis media when factors disrupt Eustachian tube function or mucosal immunity. The lactose intolerance case does not involve issues with the upper airway or middle-ear drainage, so it does not inherently raise the risk for middle-ear infections. In contrast, the child with IgA deficiency has reduced mucosal immunity, making infections more likely. The child with Down syndrome often has craniofacial anatomy and Eustachian tube dysfunction that increase fluid buildup and infection risk. The child who had cleft palate repair can continue to have altered Eustachian tube mechanics and lingering dysfunction that predispose to recurrent otitis media. Therefore, lactose intolerance is not associated with an increased risk for otitis media, whereas the others are.

Young children are especially prone to otitis media when factors disrupt Eustachian tube function or mucosal immunity. The lactose intolerance case does not involve issues with the upper airway or middle-ear drainage, so it does not inherently raise the risk for middle-ear infections. In contrast, the child with IgA deficiency has reduced mucosal immunity, making infections more likely. The child with Down syndrome often has craniofacial anatomy and Eustachian tube dysfunction that increase fluid buildup and infection risk. The child who had cleft palate repair can continue to have altered Eustachian tube mechanics and lingering dysfunction that predispose to recurrent otitis media. Therefore, lactose intolerance is not associated with an increased risk for otitis media, whereas the others are.