Risk factors

Immuno suppression in condtitions such as HIV, DM II, and other immuno-deficiencies

Genetic predisposition

Anatomic abnormalities of the palate and tensor veli palatini

Ciliary dysfunction

Cochlear implants

Vitamin A deficiency

Allergies

Passive smoke exposure

Overcrowding

Lower socioeconomic status

Family history of recurrent otitis media

Upper respiratory tract infection.