Answer to letter to the editor “Further studies are still necessary in the relationship between indoor environment and otitis media”

Dear Editor and José Lubianca Neto,

I feel very honored to receive your letter. Thank you very much for your comments and criticism of the article. The following is our reply after reading it carefully:

First, our results were derived after correction of age and were tested multiple times. The “… some pediatricians have a vague understanding of it, which leads to a missed diagnosis by physicians” mentioned in the discussion part of the paper is a phenomenon existing in some areas in the past and cannot represent the current diagnosis and treatment of otitis media in China. At the same time, the criteria for determining otitis media in this paper are all preschool children diagnosed with otitis media after examination and diagnosis by clinicians. Since this survey is a cross-sectional retrospective study, the limitations of the institute and the later improvements are also mentioned at the end of the article.

In addition, otitis media is the inflammation of the ear, usually especially otitis media and otitis media in medicine, among which acute otitis media is an infectious disease after the common cold. The “… children's hearing organs and brains were irreversibly injured due to… acute otitis attacks” mentioned in the introduction means that if children suffer from acute otitis media for a long time and are not treated, repeated attacks are easy to cause hearing loss, intracranial complications, and other diseases, causing irreversible damage to children.¹ In the discussion part, the proportion of otitis media caused by bacteria refers to the proportion of external otitis media and otitis media detected together.²

Finally, the long-term use of aminoglycosides such as gentamicin mentioned in the text does cause ototoxicity and affects the inner ear hair cells.³ This is an addition to the previously described “At the onset of otitis…”.

We agree with Professor Jose Lubianca Neto at the end of the article. This paper is indeed a retrospective cross-sectional study, with poor argumentation power compared to cohort studies. Population-based prospective cohort studies are also needed to further observe the environment and disease development during child growth and development.

Thanks again for your editorial efforts for our manuscript.