{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:58:49Z","timestamp":1785776329554,"version":"3.56.0"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To examine the association between serum cotinine and tympanometric abnormalities in US adults.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Cross\u2010sectional study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n National Health and Nutrition Examination Survey.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Adults aged 20\u2009years or older with available data on serum cotinine and tympanometry.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n The primary outcome was defined as a Type B or Type C tympanogram in either ear. Sensitivity analyses were performed for outcomes defined as a Type C tympanogram in either ear and a Type B tympanogram in either ear.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 13\u2009169 adults were included. In the fully adjusted model, higher serum cotinine was associated with higher odds of the primary tympanometric abnormality outcome. For each log\n 2<\/jats:sub>\n increase in serum cotinine, the odds ratio (OR) was 1.024 (95% confidence interval [CI], 1.011\u20131.037;\n p<\/jats:italic>\n \u2009<\u20090.001). Compared with the lowest quartile, the highest quartile had an OR of 1.295 (95% CI, 1.060\u20131.582;\n p<\/jats:italic>\n \u2009=\u20090.011), with a significant trend across quartiles (\n p<\/jats:italic>\n for trend\u2009=\u20090.009). In sensitivity analyses, the association was more evident for Type C tympanometric patterns (OR 1.570, 95% CI 1.259\u20131.957 for the highest vs. lowest quartile) than for Type B patterns, for which no significant association was observed (OR 0.652, 95% CI 0.406\u20131.048;\n p<\/jats:italic>\n \u2009=\u20090.077).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Higher serum cotinine levels were associated with higher odds of tympanometric abnormalities in US adults. The association was more apparent for Type C than for Type B tympanometric patterns, suggesting that tobacco exposure may be more closely related to negative middle\u2010ear pressure abnormalities than to nonspecific abnormal tympanograms.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/coa.70129","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T08:46:02Z","timestamp":1780649162000},"page":"736-743","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Cotinine Is Associated With Tympanometric Abnormalities Suggestive of Middle\u2010Ear Pressure Dysregulation in\n US<\/scp>\n Adults"],"prefix":"10.1111","volume":"51","author":[{"given":"Nilipaer","family":"Alimu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8476-8591","authenticated-orcid":false,"given":"Tong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayiheng","family":"Qukuerhan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology First Affiliated Hospital of Xinjiang Medical University Urumqi Xinjiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiankang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology The Second Hospital of Jiaxing Jiaxing Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12475"},{"issue":"9","key":"e_1_2_11_3_1","first-page":"1713","article-title":"Tympanometry","volume":"70","author":"Onusko E.","year":"2004","journal-title":"American Family Physician"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215120002315"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215122001190"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/oto2.166"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-69248-5_2"},{"key":"e_1_2_11_8_1","volume-title":"National Health and Nutrition Examination Survey 2017\u2013March 2020 Data Documentation, Codebook, and Frequencies: Cotinine and Hydroxycotinine \u2010 Serum (P_COT)","author":"Centers for Disease Control and Prevention, National Center for Health Statistics","year":"2022"},{"key":"e_1_2_11_9_1","volume-title":"National Health and Nutrition Examination Survey: Questionnaires, Datasets, and Related Documentation","author":"Centers for Disease Control and Prevention, National Center for Health Statistics","year":"2020"},{"key":"e_1_2_11_10_1","volume-title":"Biomonitoring Glossary: Cotinine. National Biomonitoring Program","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"e_1_2_11_11_1","volume-title":"Recommended Procedure: Tympanometry and Acoustic Reflex Thresholds","author":"British Society of Audiology","year":"2024"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1982.00790600010003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2006.08.011"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70129","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.70129","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:34:49Z","timestamp":1785774889000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.70129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/coa.70129"],"URL":"https:\/\/doi.org\/10.1111\/coa.70129","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]},"assertion":[{"value":"2025-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}