1
|
Özel HE, Pala Mutlu B, Özel MB. Cephalometric analysis in adults with tympanic membrane atelectasis. Cranio 2023:1-7. [PMID: 37732729 DOI: 10.1080/08869634.2023.2257533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVE This study aims to examine craniofacial morphology (CFM) with cephalometric radiographs in adults with tympanic membrane atelectasis (TMA). METHODS A total of 50 patients (study group) were included and standardized lateral and anteroposterior cephalograms were performed. The control group consisted of 50 patients. Anteroposterior cephalograms were compared with the normative data. RESULTS A significant increase in vertical and decrease in horizontal linear measurements were observed in lateral and anteroposterior cephalograms respectively. Except for the facial axis, the angular measurements were not statistically significant. CONCLUSION Cephalometric data indicate a narrow and elongated but nearly proportional CFM for patients with TMA.
Collapse
Affiliation(s)
- Halil Erdem Özel
- Department of Otolaryngology, University of Health Sciences, Kocaeli, Turkey
| | - Buket Pala Mutlu
- Department of Orthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Birol Özel
- Department of Orthodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| |
Collapse
|
2
|
Bardellini E, Amadori F, Garo ML, Majorana A, Conti G. Is there any correlation between otitis media and dental malocclusion in children? A systematic review. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00807-0. [PMID: 37338742 PMCID: PMC10382365 DOI: 10.1007/s40368-023-00807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/15/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE This study aims to evaluate whether there is a correlation between otitis and dental malocclusions. METHODS Electronic databases were searched for observational studies published until July 2021 without language or time restrictions. PROSPERO CRD42021270760. Observational studies on children with and without OM and/or malocclusion were included. After removing duplicates and excluding not-eligible articles, two reviewers screened relevant articles independently. Two reviewers independently extracted data and assessed data quality and validity through the Newcastle-Ottawa Scale (NOS) quality assessment tool for non-randomized studies. RESULTS Five studies met the selection inclusion criteria and were included in the studies for a total of 499 patients. Three studies investigated the relationship between malocclusion and otitis media, while the remaining two studies analyzed the inverse relationship and one of them considered eustachian tube dysfunction as a proxy of OM. An association between malocclusion and otitis media and vice versa emerged, although with relevant limitations. CONCLUSION There is some evidence that there is an association between otitis and malocclusion; however, it is not yet possible to establish a definitive correlation.
Collapse
Affiliation(s)
- E Bardellini
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy.
| | - F Amadori
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - M L Garo
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - A Majorana
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - G Conti
- University of Insubria, Varese, Italy
| |
Collapse
|
3
|
Bernkopf E, Cristalli G, de Vincentiis GC, Bernkopf G, Capriotti V. Temporomandibular Joint and Otitis Media: A Narrative Review of Implications in Etiopathogenesis and Treatment. Medicina (B Aires) 2022; 58:medicina58121806. [PMID: 36557008 PMCID: PMC9786198 DOI: 10.3390/medicina58121806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Otitis media (OM) and its recurring (rAOM), effusive (OME), and chronic forms, represent a frequent clinical challenge. The middle ear, the mandible, and the temporomandibular joint (TMJ) share several embryological and anatomical connections. Despite that, the role of mandibular malposition and TMJ dysfunction is frequently overlooked in the management of otitis media. In this narrative review, we present current evidence supporting the etiopathogenetic role of a dysfunctional stomatognathic system in the onset of OM and the effectiveness of orthognathic treatment in preventing rAOM and OME. In particular, a focus on the influence of TMJ on Eustachian tube function is provided.
Collapse
Affiliation(s)
| | - Giovanni Cristalli
- Otolaryngology Unit, Bambino Gesù Children’s Hospital, IRCCS, Via della Torre di Palidoro, 00050 Rome, Italy
- Correspondence: (G.C.); (V.C.); Tel.: +39-066-859-4135 (G.C.); +39-351-768-6445 (V.C.)
| | | | | | - Vincenzo Capriotti
- Otorhinolaryngology and Head and Neck Surgery Unit, ASST Bergamo Ovest, Treviglio-Caravaggio Hospital, Piazzale Ospedale Luigi Meneguzzo 1, 20047 Treviglio, Italy
- Correspondence: (G.C.); (V.C.); Tel.: +39-066-859-4135 (G.C.); +39-351-768-6445 (V.C.)
| |
Collapse
|
4
|
Schuenemann R, Kamradt A, Truar K, Oechtering G. Prevalence and characterization of middle ear effusion in 55 brachycephalic dogs. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2022; 50:329-336. [PMID: 36100247 DOI: 10.1055/a-1913-7216] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Multiple, breeding-related malformations of the skull of brachycephalic dogs are well-known. Whereas the eye-catching deformities of the nose that lead to dramatic respiratory problems are obvious, changes of the middle ear are often an incidental finding on CT examinations and usually clinically inapparent. The objectives of this work were to investigate the prevalence and characteristics of middle ear effusion in brachycephalic dog breeds presented for multilevel surgery of upper airway obstructions. MATERIAL AND METHODS Brachycephalic dogs with incidental middle ear effusion detected on CT scans obtained prior to surgical treatment of brachycephalic airway syndrome were prospectively enrolled. A perendoscopic tympanocentesis followed by macroscopic description, microscopic cytology and bacteriological analysis of the fluid was performed. RESULTS Prevalence of middle ear effusion in all dogs presented to the department during the study period was 55/170 (32 %) in 86 middle ears. The only breeds suffering from MEE were French Bulldogs (FB) with a prevalence of 35/66 (53 %) and Pugs with a prevalence of 20/79 (25 %). Tympanocentesis was performed in 80 ears. In the majority of cases the effusion was either mucoid or serous, with a honey-like or ochre colour.Bacteriology was available for 76 ears and tested positive in 34 (45 %) cases. Cytology was performed in 73 ears and revealed all effusions to contain inflammatory cells with a high concentration in 23 (31.5 %) cases. CONCLUSIONS AND CLINICAL RELEVANCE Brachycephalic dogs presented for surgical treatment of brachycephalic airway syndrome have a high prevalence of incidental middle ear effusions. Cytological findings differ from previously reported analyses of effusions in Cavalier King Charles spaniels with clinical symptoms of primary secretory otitis media, where usually cell-free effusions are found. A study comparing effusions of brachycephalic dogs with vestibular disease to those found as an incidental condition is warranted.
Collapse
Affiliation(s)
- Riccarda Schuenemann
- Department for Small Animals, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Anne Kamradt
- Department for Small Animals, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Katrin Truar
- Department for Small Animals, Faculty of Veterinary Medicine, University of Leipzig, Germany
| | - Gerhard Oechtering
- Department for Small Animals, Faculty of Veterinary Medicine, University of Leipzig, Germany
| |
Collapse
|
5
|
Aslıer M, Aslıer NGY, Ercan İ, Keskin S. Clustering upper airway physicals, otitis media with effusion and auditory functions in children. Auris Nasus Larynx 2021; 49:195-201. [PMID: 34304942 DOI: 10.1016/j.anl.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/08/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Adenoid hypertrophy (AH) has been identified as a cause of otitis media with effusion (OME), which is the most common cause of childhood hearing loss. Indeed, there may be other upper airway-related predisposing factors such as, location of the adenoid, accompanying tonsillar hypertrophy (TH) and nasal septal deviation (NSD) for the development of OME. In this study, we aimed to evaluate the associations between the upper airway physicals and OME with auditory functions. METHODS Eighty-six ears of 43 children, aged 3-11 years were included in this prospective clinical study. Findings of otolaryngologic examinations were noted. Data of pure tone audiometry (PTA), traditional tympanometry (TT) and wideband tympanometry (WBT) parameters were collected. Cluster analysis was performed to the following variables: age, sex; the adenoid choana percentage (ACP), the presences of adenoid around torus tubarius (AATT), TH, NSD and OME; peak pressure (PP) values on TT, resonance frequencies (RF) on WBT, ambient pressure absorbance ratios (APAR) and PTA hearing thresholds. RESULTS Two groups of ears revealed by clustering; cluster-1 (n = 46) and cluster-2 (n = 40), at the similarity level of 0.662. The presences of AH, AATT, OME and the medians of ACP, PP, RF, WBT APARs at all frequencies except 5656 Hz and 8000 Hz, all PTA thresholds were significantly different between two clusters (p < 0.05). The lower WBT APARs and higher PTA thresholds were associated with higher levels of ACP and higher frequencies of the presence of AATT and OME in cluster-1. CONCLUSION There are associations between AH, AATT and OME together with decline in hearing and SEA. Whereas, TH and NSD are not related to the formation of clusters and they are insignificant factors.
Collapse
Affiliation(s)
- Mustafa Aslıer
- Department of Otorhinolaryngology, Sancaktepe Education and Research Hospital, Istanbul, Turkey.
| | | | - İlker Ercan
- Department of Biostatistics, Uludağ University School of Medicine, Bursa, Turkey
| | - Serhan Keskin
- Department of Otorhinolaryngology, Sancaktepe Education and Research Hospital, Istanbul, Turkey
| |
Collapse
|
6
|
Pagano AS, Márquez S, Smith CM, Laitman JT. Identification of critical windows in early development of human upper respiratory tract and middle ear disease. Anat Rec (Hoboken) 2021; 304:1953-1973. [PMID: 33586870 DOI: 10.1002/ar.24600] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 12/23/2022]
Abstract
Otitis media (OM) or middle ear disease is a prevalent pediatric condition generally related to early growth of the cartilaginous Eustachian tube (CET). This study used a developmental series of dry crania to reconstruct CET and dilator tubae (DT, the muscle opening the CET) morphology. Timing and directionality of CET and upper respiratory tract (URT) growth were investigated. Traditional and 3D geometric morphometrics (GM) were used to assess bony landmarks on the crania. The series was divided using dental eruption into seven growth stages ranging from before eruption of deciduous dentition (approximately the first 6 postnatal months) to eruption of the first permanent maxillary molar (after approximately 6 years). Bony endpoints of the CET and DT were used to calculate their morphology. GM analysis showed substantial shape differences between newborns, early infants, and all later developmental stages. Univariate measures showed the largest growth change between birth and 6 months. Subsequently, CET morphology changed little in the latter half of year 1, instead maturing gradually until approximately 3 years whereas DT relative length and orientation finish growth by the end of year 1. Incongruence in slower CET growth and faster DT growth could impact CET function between 6 and 12 months and be a contributing factor of OM. Tubal aeration may improve after this time when both CET and DT morphology mature, coinciding with clinically reported drop-off in ear infections.
Collapse
Affiliation(s)
- Anthony S Pagano
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Samuel Márquez
- Department of Cell Biology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Christopher M Smith
- Department of Anthropology, CUNY Graduate Center, New York, New York, USA.,New York Consortium in Evolutionary Primatology (NYCEP), New York, New York, USA.,Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeffrey T Laitman
- Department of Anthropology, CUNY Graduate Center, New York, New York, USA.,New York Consortium in Evolutionary Primatology (NYCEP), New York, New York, USA.,Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
7
|
Abdel Tawab HM, Tabook SMS. Correlation Between Adenoid Hypertrophy, Tympanometry Findings, and Viscosity of Middle Ear Fluid in Chronic Otitis Media With Effusion, Southern Oman. EAR, NOSE & THROAT JOURNAL 2019; 100:NP141-NP146. [PMID: 31547716 DOI: 10.1177/0145561319875438] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this condition. It has been mentioned that with increased size of the adenoid tissue, the more likely the incidence of fluid in the middle ear. The aim of this study was to find whether there is a correlation between adenoid size, tympanometric findings, and type of fluid in the middle ear irrespective of disease duration. This is a prospective study done on 100 pediatric patients (12 years and less) presented with chronic otitis media with effusion (COME) and adenoid hypertrophy from July 2015 till July 2017. Cases with tympanometry evidence of COME (B, Cs) and adenoid hypertrophy seen by nasal endoscopy were included. Adenoid size was graded and correlated with the type of tympanometry and type of fluid in the middle ear. Sixty male children and 40 female children were involved. Age ranged from 3 to 12 years with a mean of 7.19 ± 2.489 years. Highly significant relation existed between grade 4 adenoid hypertrophy and mucoid nature of middle ear fluid (P value = .000). There is a highly significant relation between adenoid hypertrophy grade Ⅳ and type B tympanometry. There is a highly significant relation between adenoid size and nature of middle ear fluid irrespective of the duration of complaints, where grade Ⅳ adenoid hypertrophy showed more increase in middle ear effusion viscosity making adenoid size a very important predictor for the tympanometry type and the nature of the fluid in the middle ear.
Collapse
Affiliation(s)
- Hazem M Abdel Tawab
- Department of Otorhinolaryngology, Sultan Qaboos Hospital, Salalah, Oman.,Faculty of Medicine, 63526Cairo University, Cairo, Egypt
| | | |
Collapse
|
8
|
Hawley K, Vachhani N, Anne S. Can lateral nasopharyngeal radiographs be used to predict eustachian tube dysfunction? EAR, NOSE & THROAT JOURNAL 2018; 96:E1-E5. [PMID: 28846790 DOI: 10.1177/014556131709600801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The objective of our case-control study was to determine whether craniofacial features on lateral nasopharyngeal radiographs (LNPRs) can predict eustachian tube dysfunction (ETD). The study included patients seen in the otolaryngology clinic from 2005 to 2011. Patients 0 to 10 years old with pressure equalization tube (PET) placement and LNPR within 6 months were included. Measurements were compared with age-matched controls selected at random to identify craniofacial features associated with ETD. Using receiver operating curve methodology, selected measurements were used to correlate age, craniofacial features, and ETD. The study population consisted of 32 patients and 34 controls. No significant differences were found between groups on any individual measurement: cranial base angle; lengths of anterior, middle, and total skull base; mandible; hard and soft palates; sella-soft-palate tip; sella-posterior nasal spine; and nasopharyngeal and palatal airway. Further statistical analysis demonstrated that patients who required PETs were more likely to have shortened anterior cranial base and maxilla relative to mandibular length. Contrary to the findings of previous studies, no single measurement was found to identify craniofacial features that may select for children with ETD requiring PETs. However, younger patients with a smaller cranial base and/or maxilla relative to mandibular length are more likely to require PETs, implying persistent ETD.
Collapse
Affiliation(s)
- Karen Hawley
- Head and Neck Institute, Desk A71, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA.
| | | | | |
Collapse
|
9
|
Hearing sensitivity in adults with a unilateral cleft lip and palate after two-stage palatoplasty. Int J Pediatr Otorhinolaryngol 2017; 94:76-81. [PMID: 28167017 DOI: 10.1016/j.ijporl.2016.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/24/2016] [Accepted: 12/24/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate long-term hearing and middle ear status in patients treated for a unilateral complete cleft lip and palate (UCLP) by two-stage palatoplasty. METHODS Forty-nine UCLP patients aged 17 years and older were included in this retrospective study. Patients were invited for a multidisciplinary long-term follow-up of their treatment at a tertiary center for craniofacial surgery in the Netherlands. ENT assessment included tympanometry and pure-tone audiometry. Medical files were searched for medical and surgical history. RESULTS In total, 19.4% of the patients had significant long-term hearing loss (PTA > 20 dB), comprising conductive hearing loss in 21.5% of the patients. In the majority (70%), this hearing loss was more pronounced at higher frequencies. In 25% the high fletcher index showed hearing thresholds above 20 dB. Ventilation tubes were placed at least once in 78.7% of the patients. The frequency of tube insertion was positively correlated with the incidence of reduced tympanic compliance (tympanogram type B) and the need for a pharyngoplasty. CONCLUSION The present study reports long-term hearing outcomes in UCLP patients with hard palate closure at 3 years of age. Persistent hearing loss was observed in 19.4% of our patients (PTA > 20 dB), mainly at the higher frequencies. Ventilation tube placement was associated with reduced tympanic compliance and higher risk on hearing loss (PTA air conduction). Our high incidence of velopharyngeal incompetence during early childhood, which is likely associated with Eustachian tube dysfunction, might have contributed to these results.
Collapse
|
10
|
Tympanometric Findings among Children with Adenoid Hypertrophy in Port Harcourt, Nigeria. Int J Otolaryngol 2016; 2016:1276543. [PMID: 27563311 PMCID: PMC4985572 DOI: 10.1155/2016/1276543] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 07/05/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction. Adenoid hypertrophy (AH) is a common childhood disorder. Adenoid plays a significant role in the pathogenesis of otitis media with effusion (OME). The aim of this study is to critically appraise the tympanometric finding among children with adenoid hypertrophy in Port Harcourt, Nigeria. Methodology. A Prospective, controlled study carried out among newly diagnosed cases of adenoid hypertrophy at the ENT clinic of the UPTH, between November 2014 and June 2015. Tympanometry was done on each child and each ear was considerably studied as a single entity. Types B and C tympanograms were used as indicators of OME. Data was collected and analyzed using SPSS version 20. Results. Sixty-eight cases of adenoid hypertrophy were seen within the study period and 136 ears were studied. Forty (29.4%) ears had type B tympanogram, while 36 (26.5%) ears had type C. The incidence of OME was 55.9%; there were 12 (17.6%) unilateral OME, while bilateral OME was 32 (47.1%). Grade 3 AH was prevalent and was statistically significant with the OME. Conclusion. This study had shown adenoidal hypertrophy as a significant risk factor for OME in children. There was more bilateral OME than unilateral. The more severe grade of AH was more prevalent and it was shown to be statistically significant with OME, thus being a significant risk factor for OME in children. This establishes the need for prompt hearing evaluation and management.
Collapse
|
11
|
Gremba AP, Weinberg SM, Swarts JD, Casselbrant ML. Craniofacial shape in children with and without a positive otitis media history. Int J Pediatr Otorhinolaryngol 2016; 84:110-5. [PMID: 27063764 PMCID: PMC4839180 DOI: 10.1016/j.ijporl.2016.02.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/12/2016] [Accepted: 02/27/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Past studies using traditional morphometric approaches have reported a handful of differences in craniofacial dimensions between individuals with and without otitis media (OM). In this study, a geometric morphometry (GM) approach was used to determine if craniofacial shape is different among children with no history of OM and a history of recurrent acute OM (RAOM) at two different ages. METHODS Nineteen standard landmarks were identified on lateral cephalometric radiographs from 79 children (41 Control, 38 RAOM) at 4 years and 52 children (27 Control, 25 RAOM) at 6 years of age. Following Procrustes superimposition of the landmark coordinate data, comparisons of group differences in overall size and shape were performed. Discriminant function analysis and principal component analysis were used to determine which, if any, aspects of shape variation distinguished RAOM from Control groups. RESULTS At 4 years of age, craniofacial size and shape were significantly different between RAOM and Control groups (p<0.05). Shape differences were evident in the relative positions of the mandible, cranial base, external acoustic meatus, sphenoid and palate. Those shape differences were not found in the 6-year old group. CONCLUSIONS At 4 years of age, the RAOM and Control groups have distinct craniofacial morphologies, but by 6 years of age these differences have largely disappeared. This is consistent with the clinical observation that excess RAOM risk resolves around 6 years of age and the hypothesis that this resolution is partially a result of age-related craniofacial changes.
Collapse
Affiliation(s)
- Allison P. Gremba
- Department of Anthropology, University of Pittsburgh College of Arts and Sciences, United States,Corresponding author at: University of Pittsburgh, Department of Anthropology, 3302 WWPH, Pittsburgh, PA 15260, United States. Tel.: +1 412 728 2455. (A.P. Gremba)
| | - Seth M. Weinberg
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, United States
| | - J. Douglas Swarts
- Department of Otolaryngology, University of Pittsburgh School of Medicine, United States
| | | |
Collapse
|
12
|
Avci S, Ergun T, Aydin E, Kansu L. Sex differences in adult craniofacial parameters. Surg Radiol Anat 2015; 37:1069-78. [PMID: 25935592 PMCID: PMC4615669 DOI: 10.1007/s00276-015-1477-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 04/25/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare normal male and female craniofacial parameters in adults and evaluate associations of sex and intercochlear distance with other craniofacial parameters. METHODS In 60 normal adults (30 men and 30 women) who had no otitis media, craniofacial parameters were measured retrospectively on two-dimensional reformatted computed tomography scans. RESULTS Compared with women, men had significantly greater mean osseous auditory tube length, cartilaginous auditory tube length, mastoid length, intercochlear distance, sella to posterior nasal spine distance, sella to basion distance, and nasopharynx sagittal area. The intercochlear distance was significantly correlated with mastoid depth, midpoint of the pharyngeal opening distance, sella to nasion distance, and nasopharynx sagittal area and inversely with angle of the auditory tube. Most men and women had Körner septum present, and mean thickness of Körner septum was significantly greater in men than women. CONCLUSIONS Some craniofacial parameters, especially vertical parameters, differ with sex. These differences begin in childhood and continue in adulthood. Sex must be considered when planning a craniofacial morphologic study, and results of a craniofacial morphologic study should be evaluated with caution when there is no sex matching of the patient and control groups.
Collapse
Affiliation(s)
- Suat Avci
- Department of Otolaryngology-Head and Neck Surgery, Baskent University, Saray Mah. Yunusemre Cad. No. 1, Alanya, 07400, Antalya, Turkey.
| | - Tarkan Ergun
- Department of Radiology, Baskent University, Ankara, Turkey
| | - Erdinc Aydin
- Department of Otolaryngology-Head and Neck Surgery, Baskent University, Saray Mah. Yunusemre Cad. No. 1, Alanya, 07400, Antalya, Turkey
| | - Leyla Kansu
- Department of Otolaryngology-Head and Neck Surgery, Baskent University, Saray Mah. Yunusemre Cad. No. 1, Alanya, 07400, Antalya, Turkey
| |
Collapse
|
13
|
Cayé-Thomasen P, Hermansson A, Bakaletz L, Hellstrøm S, Kanzaki S, Kerschner J, Lim D, Lin J, Mason K, Spratley J. Panel 3: Recent advances in anatomy, pathology, and cell biology in relation to otitis media pathogenesis. Otolaryngol Head Neck Surg 2013; 148:E37-51. [PMID: 23536531 DOI: 10.1177/0194599813476257] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 01/08/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES The pathogenesis of otitis media (OM) involves a number of factors related to the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx. Although some issues of pathogenesis are fairly well established, others are only marginally indicated by current knowledge, and yet others remain undisclosed. The objective of this article is to provide a state-of-the-art review on recent scientific achievements in the pathogenesis of OM, as related to anatomy, pathology, and cell biology. DATA SOURCES PubMed, Ovid Medline, and Cochrane Library. REVIEW METHODS Articles published on the pathogenesis of OM and the anatomy, pathology, and cell biology of the middle ear, the mastoid, the Eustachian tube, and the nasopharynx between January 2007 and June 2011 were identified. Among almost 1900 abstracts, the authors selected 130 articles for full article review and inclusion in this report. RESULTS New knowledge on a number of issues emerged, including cell-specific expression and function of fluid transportation and innate immune system molecules, mucous cell metaplasia, mucin expression, bacterial adherence, and epithelial internalization, as well as the occurrence, composition, dynamics, and potential role of bacterial biofilm. In addition, the potential role of gastroesophageal reflux disease and cigarette smoke exposure has been explored further. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Over the past 4 years, considerable scientific progress has been made on the pathogenesis of OM, as related to issues of anatomy, pathology, and cell biology. Based on these new achievements and a sustained lack of essential knowledge, suggestions for future research are outlined.
Collapse
Affiliation(s)
- Per Cayé-Thomasen
- Department of Oto-rhino-laryngology, Head and Neck Surgery, University Hospital of Copenhagen, Copenhagen, Denmark.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
McGuinness SJ, Friend EJ, Knowler SP, Jeffery ND, Rusbridge C. Progression of otitis media with effusion in the Cavalier King Charles spaniel. Vet Rec 2013; 172:315. [DOI: 10.1136/vr.101337] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- S. J. McGuinness
- School of Veterinary Sciences; University of Bristol; Bristol UK
| | - E. J. Friend
- School of Veterinary Sciences; University of Bristol; Bristol UK
| | | | - N. D. Jeffery
- Department of Veterinary Clinical Sciences; Iowa State University USA
| | | |
Collapse
|
15
|
Casselbrant ML, Swarts JD, Mandel EM, Doyle WJ. The Cephalic Index is not different among groups of children aged 36-48 months with chronic otitis media with effusion, recurrent acute otitis media and controls. Int J Pediatr Otorhinolaryngol 2013; 77:334-7. [PMID: 23280277 PMCID: PMC3570633 DOI: 10.1016/j.ijporl.2012.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/27/2012] [Accepted: 11/03/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The Cephalic Index, an anthropometric measure of head shape, was reported to be different between individuals with and without signs of past or concurrent otitis media (OM). In this study, we compared the Cephalic Index and other measures of head shape among groups of children aged 36-48 months with a documented history of chronic OM with effusion (COME), recurrent acute OM (RAOM) and CONTROLS (few to no OM episodes) to test that hypothesis. METHODS In 41 CONTROL, 36 COME and 42 RAOM children, Maximum Head Width, Maximum Head Length and Head Circumference were measured and the Cephalic Index (Head Width/Head Length×100) was calculated. The four measures were compared among the three groups using a General Linear Model that included group, sex and race as factors and age as a covariate. RESULTS There were no differences among groups in the Cephalic Index or Head Length. Head Width was significantly smaller in the RAOM when compared to the CONTROL group and Head Circumference was significantly smaller in the RAOM and COME groups when compared to the CONTROL group. For all measures, the distribution of values showed significant overlap among groups. CONCLUSIONS These results do not support the hypothesis that the Cephalic Index is different between young children with and without OM, but did document differences in Head Width and Circumference among groups. However, the large overlap in each measure for the three groups suggests that none capture sufficient information on Eustachian tube anatomy to predict disease presentation.
Collapse
Affiliation(s)
- Margaretha L Casselbrant
- Department of Otolaryngology, Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | | |
Collapse
|
16
|
Morin C, Dorion D, Moutquin JM, Levasseur M. Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study. BMC Pediatr 2012; 12:181. [PMID: 23167940 PMCID: PMC3529688 DOI: 10.1186/1471-2431-12-181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 11/18/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eustachian tube (ET) dysfunction plays an important role in the pathogenesis of acute otitis media (AOM). Unfortunately, there is a lack of knowledge about the exact role of the ET's bony support, the temporal bone, on occurrence of AOM. This study investigates whether severe suture restriction of the temporal bone is a risk factor for development of AOM in young children. METHODS Using a prospective cohort design, 64 children aged 6 to 18 months without prior history of AOM were followed during the cold season (September 2009 to April 2010). Temporal bone status (categorized as with or without severe suture restriction) was evaluated using palpation and a cranial bone mobility test. Information about potential baseline confounders and risk factors for AOM (gender, age, birth weight, gestational age, use of pacifier, daycare attendance, presence of siblings, low socioeconomic status, breastfeeding ≥ 6 months, parental smoking and history of upper respiratory tract infection) were also collected. Occurrence of AOM diagnosed by physicians blinded to temporal bone status was the main outcome. Data were analyzed using hierarchical linear and nonlinear (multilevel) models. RESULTS Severe suture restriction of the temporal bone was identified in 23 children (35.9%). At least one AOM episode was diagnosed in 14 (48.3%) of the ears associated with temporal bones previously identified as having severe suture restriction and in 28 (28.3%) of those without severe suture restriction. Higher risk for AOM was explained by severe suture restriction of the temporal bone (adjusted relative risk (RR), 2.26, 95% CI 1.43 to 2.91, p<.01), pacifier use (RR, 2.59, 95% CI 1.51 to 3.22, p<.01) and younger age (RR, 0.22, 95% CI 0.10 to 0.52, p=.001). CONCLUSIONS The study results indicate that severe suture restriction of the temporal bone is a risk factor for AOM in young children. Subsequent intervention studies are needed to determine if this mechanical risk factor can be modified in young children.
Collapse
Affiliation(s)
- Chantal Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC J1H 5N4, Canada
| | - Dominique Dorion
- Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC, J1H 5N4, Canada
| | - Jean-Marie Moutquin
- Department of Obstetrics-Gynecology, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC, J1H 5N4, Canada
- National Institute of Excellence in Health and Social Services, 2021, Avenue Union, bureau 10.082, Montréal, QC, H3A 2S9, Canada
| | - Mélanie Levasseur
- School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC J1H 5N4, Canada
| |
Collapse
|
17
|
Abstract
Chronic rhinosinusitis (CRS) is a rather common disease in children, but its symptoms are often subtle and non-specific and this may result in overlooking a correct diagnosis. In turn, a missed diagnosis of CRS prevents a correct management to be performed and is associated with uneffective investigations and improper treatments. Actually, when CRS symptoms, which are mainly nasal congestion and obstruction, nasal discharge, facial pain, cough, and halitosis, are correctly assessed, the clinical diagnosis of CRS may be achieved, and confirmation may be obtained by imaging criteria or nasal fibroendoscopy. In imaging, computed tomography (CT) is the first choice technique for the evaluation of CRS and is able to provide an anatomic road map when surgery is required. Magnetic resonance imaging (MRI) of the sinuses, orbits, and brain should be performed whenever extensive or multiple complications of sinusitis are suspected. Also for middle ear disorders, CT is the first choice because it detects opacification of the middle ear cavity and mastoid cells, presence of fluids or debris, and allows the ossicular chain and the cortical bone of the mastoid to be evaluated. Another important diagnostic issue is the need to look for disorders that are frequently associated with CRS, such as obstructive sleep apnea syndrome (OSAS), that has some recognized risk factors in adenotonsillar hypertrophy, craniofacial anomalies, obesity, and neuromuscular disorders. Other associated disorders requiring investigation are recurrent or persistent otitis media and difficult asthma.
Collapse
Affiliation(s)
- Gualtiero Leo
- Pediatric Allergy and Respiratory Pathophysiology Unit, Buzzi Children's Hospital, Istituti Clinici di Perfezionamento, Via Castelvetro 32, Milan, Italy.
| | | | | |
Collapse
|
18
|
Giuca MR, Caputo E, Nastasio S, Nastassio S, Pasini M, Passini M. Correlation between otitis media and dental malocclusion in children. Eur Arch Paediatr Dent 2011; 12:241-4. [PMID: 21993063 DOI: 10.1007/bf03262815] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To determine the possible correlation between otitis media and dental malocclusion in children. METHODS Fifty subjects (26 males and 24 females; mean age: 7.8 +/- 1 years) were assessed: 25 patients, with otitis media formed the study group, while 25 healthy subjects formed the control group. An otolaryngological examination and dental cast measurements were performed in order to evaluate adenoids, tonsils and dental relationships, respectively. RESULTS A significant correlation (p<0.05) was found between otitis media and enlargement of adenoids (13 patients, 52% in the study group) and tonsils (11 patients, 44% in the study group). Furthermore, a significant predominance (p<0.05) of posterior crossbite was found in the study group (19 children, 76%), in comparison to the control group (4 children, 16%). No correlation between otitis media and overjet, overbite, Angle Class relationship, or inadequate oral habits were found. CONCLUSIONS Posterior cross-bite and adenoids-tonsils enlargement are factors significantly associated with otitis media in children.
Collapse
Affiliation(s)
- M R Giuca
- Dept. of Surgery, Unit of Paediatric Dentistry
| | | | | | | | | | | |
Collapse
|
19
|
Ralli G, Ruoppolo G, Mora R, Guastini L. Deleterious sucking habits and atypical swallowing in children with otitis media with effusion. Int J Pediatr Otorhinolaryngol 2011; 75:1260-4. [PMID: 21802155 DOI: 10.1016/j.ijporl.2011.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 07/01/2011] [Accepted: 07/02/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the possible correlation between otitis media with effusion, bad sucking habits and atypical swallowing in children affected by otitis media with effusion. METHODS 65 children, aged from 7 to 12 years, observed in the ENT Department of the "La Sapienza" University of Rome, were enrolled in the study group (group A). All children were affected by otitis media with effusion for more than 3 months. As control group, 60 healthy children, aged from 7 to 12 years were identified (group B). All the children underwent medical history, with evaluation of the sucking habits, ENT examination, tympanometry, orthodontic examination and evaluation of swallowing. In the orthodontic examination the variables analyzed were: maximum mouth opening, right and left mandibular lateral movements and mandibular protrusion. Atypical swallowing was considered to occur when lip activity produced strong tension in the perioral musculature, and/or the tip of the tongue was placed or pushed against the anterior teeth during swallowing. RESULTS In the group A, atypical swallowing was found in 33/65 subjects out of the 65 children (50.7%). In the control group (group B) 16/60 children (26.6%) showed atypical swallowing. Compared with group B, deleterious sucking habits were significantly higher (p<0.05) in the study group (28/65 vs. 12/60). In both the study and control group, deleterious sucking habits were present in almost all children with atypical swallowing (28/33 in group A and 12/16 in group B). CONCLUSIONS Our data suggest a correlation between otitis media with effusion, deleterious sucking habits and prevalence of atypical swallowing.
Collapse
|
20
|
Yang B, Tian C, Zhang ZG, Han FC, Azem R, Yu H, Zheng Y, Jin G, Arnold JE, Zheng QY. Sh3pxd2b mice are a model for craniofacial dysmorphology and otitis media. PLoS One 2011; 6:e22622. [PMID: 21818352 PMCID: PMC3144925 DOI: 10.1371/journal.pone.0022622] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Accepted: 06/26/2011] [Indexed: 11/18/2022] Open
Abstract
Craniofacial defects that occur through gene mutation during development increase vulnerability to eustachian tube dysfunction. These defects can lead to an increased incidence of otitis media. We examined the effects of a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) on the progression of otitis media and hearing impairment at various developmental stages. We found that all mice that had the Sh3pxd2bnee mutation went on to develop craniofacial dysmorphologies and subsequently otitis media, by as early as 11 days of age. We found noteworthy changes in cilia and goblet cells of the middle ear mucosa in Sh3pxd2bnee mutant mice using scanning electronic microscopy. By measuring craniofacial dimensions, we determined for the first time in an animal model that this mouse has altered eustachian tube morphology consistent with a more horizontal position of the eustachian tube. All mutants were found to have hearing impairment. Expression of TNF-α and TLR2, which correlates with inflammation in otitis media, was up-regulated in the ears of mutant mice when examined by immunohistochemistry and semi-quantitative RT-PCR. The mouse model with a mutation in the Sh3pxd2b gene (Sh3pxd2bnee) mirrors craniofacial dysmorphology and otitis media in humans.
Collapse
Affiliation(s)
- Bin Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Cong Tian
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Zhi-guang Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- * E-mail: (QYZ); (ZgZ)
| | - Feng-chan Han
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Rami Azem
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Heping Yu
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ye Zheng
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Ge Jin
- School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - James E. Arnold
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Qing Y. Zheng
- Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail: (QYZ); (ZgZ)
| |
Collapse
|
21
|
RESTREPO C, SANTAMARÍA A, PELÁEZ S, TAPIAS A. Oropharyngeal airway dimensions after treatment with functional appliances in class II retrognathic children. J Oral Rehabil 2011; 38:588-94. [DOI: 10.1111/j.1365-2842.2011.02199.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
22
|
Krasny M, Wysocki J, Zadurska M, Skarżyński PH. Relative nasopharyngeal patency index as possible objective indication for adenoidectomy in children with orthodontic problems. Int J Pediatr Otorhinolaryngol 2011; 75:250-5. [PMID: 21129788 DOI: 10.1016/j.ijporl.2010.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 11/04/2010] [Accepted: 11/08/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although the harmful influence of nasopharyngeal obstruction on the facial skeleton has been demonstrated, clear criteria to qualify children with adenoid hypertrophy and malocclusion for adenoidectomy have not been established yet. METHODS Retrospective analysis of 148 patients qualified for orthodontic treatment (77 females and 71 males) at the age of 9-11 years (the average age was 10 years and 3 months). X-ray images performed with the use of a cephalostat were scanned and submitted for cephalometric assessment. The study investigated the correlation between standard cephalometric parameters and the value of relative nasopharyngeal flow defined as the ratio of the nasopharyngeal flow to the dimension of the entire nasopharynx. In statistics Bartlett's test, Tukey's test and Pearson's correlation coefficients were used. RESULTS The value of relative nasopharyngeal lumen ranged from 0.0943 to 0.5532 with no significant differences between genders. The subjects were divided into decile groups for investigating the correlation with cephalometric parameters. The study demonstrated statistically significant negative correlations between relative nasopharyngeal flow and the following parameters: the angle between lines NA and NB (ANB), the angle between lines SN and ML (SN/ML), the posterior/anterior facial height ratio (Post.Fac.H./Ant.Fac.H.), the difference between the maxillary and mandibular length (difference maxillary/mandibular), the mandibular length (Co-Gn) and the lower anterior facial height (Sn-Me). The correlations generally referred to middle deciles: from the 40th to 80th decile. An apparent lack of significant correlations in patients located below the 40th decile, which corresponded to the value of relative nasopharyngeal flow up to 18%, may indicate, that this value constitutes a threshold and further decreasing it exceeds adaptive capabilities of the body. CONCLUSIONS Relative nasopharyngeal flow below 38% should constitute an indication for adenoidectomy, due to the exceeded adaptive capabilities of the body.
Collapse
|
23
|
Hayes GM, Friend EJ, Jeffery ND. Relationship between pharyngeal conformation and otitis media with effusion in Cavalier King Charles spaniels. Vet Rec 2010; 167:55-8. [PMID: 20622204 DOI: 10.1136/vr.b4886] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Otitis media with effusion (OME) is a common incidental finding in otherwise normal Cavalier King Charles spaniels (CKCS). In this study, measurements made on MRI were used to determine whether there was an association between OME and brachycephalic conformation. The results confirm that association and also demonstrate that, in CKCS, greater thickness of the soft palate and reduced nasopharyngeal aperture are significantly associated with OME. These results suggest that auditory tube dysfunction and OME may represent a previously overlooked consequence of brachycephalic conformation in dogs.
Collapse
Affiliation(s)
- G M Hayes
- Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.
| | | | | |
Collapse
|
24
|
Toros SZ, Kiliçoğlu G, Noşeri H, Naiboğlu B, Kalaycik C, Külekçi S, Karaca CT, Habeşoğlu T. Does adenoid hypertrophy really have effect on tympanometry? Int J Pediatr Otorhinolaryngol 2010; 74:365-8. [PMID: 20096937 DOI: 10.1016/j.ijporl.2009.12.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 12/21/2009] [Accepted: 12/29/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The goal of this study is to determine the correlation between the radiographic measurements of adenoid size and tympanometric findings. STUDY DESIGN Prospective study. SETTING Haydarpasa Numune Research and Education Hospital, Istanbul, Turkey. SUBJECTS AND METHODS Nine five consecutive children complaining of one or more of the symptoms of upper airway obstruction (UAO) (presence of snoring, mouth breathing or difficulty in breathing during sleep, obstructive breathing or apnea during sleep) were included in the study. Symptom severity was assessed by a standardized questionnaire. All patients underwent digital lateral soft tissue radiographs. Assessment of nasopharyngeal obstruction in radiographs was done according to four different methods. Tympanometry was used to evaluate the middle ear. RESULTS Of 190 ears, 79 were type A, 49 were type B and 62 were type C tympanograms. The symptom severity of 14 patients was graded as mild, 56 patients as moderate and 25 patients as severe. There was no statistically significant difference between UAO symptom severity groups and tympanogram types (p>0,05). Each one of the four methods of radiologic measurements of the adenoid enlargement showed no statistically significant difference between the tympanogram types (p>0,05). CONCLUSION The adenoid hypertrophy in both means of radiologic measurements and symptom severity does not correlate with the changes in tympanograms. These findings do not support the hypothesis that adenoidal size plays a major role in the etiopathogenesis of middle ear effusion (MEE).
Collapse
Affiliation(s)
- Sema Zer Toros
- Department of Otorhinolaryngology/Head and Neck Surgery, Haydarpaşa Numune Educational and Research Hospital, Istanbul, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Patency of nasopharynx and a cephalometric image in the children with orthodontic problems. Int J Pediatr Otorhinolaryngol 2009; 73:1803-9. [PMID: 19879660 DOI: 10.1016/j.ijporl.2009.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Revised: 09/29/2009] [Accepted: 10/01/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To study a possible impact of adenoidectomy on malocclusion on the base of cephalometry. METHODS Retrospective analysis of 148 patients qualified into the orthodontic treatment (77 girls and 71 boys) at the age of 9-11 years (an average age: 10 years and 3 months). Material was divided into three groups, equalized regarding sex and age. The first one consisted of the patients after adenoidectomy, at the moment of orthodontic assessment without any organic pathology within a nasal cavity or nasopharynx. To the second group were included children who for different reasons were not a subject of adenoidectomy despite clinical diagnosis of adenoid hypertrophy. In the third group were patients whose only problem was malocclusion. X-ray pictures taken on a cephalostate were scanned and given to cephalometric assessment. In statistics Bartlett's test, Tukey's test and Pearson's correlation coefficients were used. RESULTS The significant differences with respect to many skull parameters appeared among the groups. The inappropriate respiratory habits find their reflection mainly within anterior and lower anterior facial height, angle of mandibular plane, nasopharyngeal flow and dental parameters. An evident beneficial influence of adenoidectomy is observed within a period of 36-41 months after an operation. Nasopharyngeal flow is the most sensitive parameter indicating the respiratory conditions, and is strongly connected with the key cephalometric parameters. CONCLUSIONS In cases of malocclusion of skeletal character, coexisting with adenoid hypertrophy, adenoidectomy should be carried out as early as possible.
Collapse
|
26
|
Verd S, Rodríguez M. The mid-face in otitis media. Int J Pediatr Otorhinolaryngol 2009; 73:1174. [PMID: 19443051 DOI: 10.1016/j.ijporl.2009.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Accepted: 04/07/2009] [Indexed: 11/24/2022]
|