In which age group is the incidence of otitis media highest?

The incidence of otitis media is highest in children aged 6 to 24 months due to several anatomical and developmental factors. During this age range, children have a shorter and more horizontal Eustachian tube, which makes it easier for pathogens from the nasopharynx to reach the middle ear, increasing the likelihood of infections. Additionally, this age group is often still undergoing frequent colds and respiratory infections, which contribute to middle ear infections.

Infants less than 6 months are less frequently affected than older infants and toddlers, as breastfeeding can provide some protective factors against infections. Children aged 2 to 4 years have a lower incidence compared to the 6 to 24-month group, likely due to some development in their Eustachian tube anatomy and an improvement in immunity from previous infections. Adolescents, ages 12 to 18 years, typically have a much lower incidence of otitis media, as their anatomical structures are more developed, reducing the risk of this condition. Thus, the highest incidence of otitis media is indeed seen in the 6 to 24-month age group.