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BMC Pediatrics

, 12:181

General pediatric medicine and surgery

Abstract

BackgroundEustachian 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.

MethodsUsing 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.

ResultsSevere 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.

ConclusionsThe 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.

KeywordsAcute otitis media Temporal bone Children Eustachian tube Risk factor Cohort Cranial suture Osteopathy AbbreviationsETEustachian tube

AOMAcute otitis media

RRRelative Risk

OMOtitis media

OROdd Ratio.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2431-12-181 contains supplementary material, which is available to authorized users.

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Autor: Chantal Morin - Dominique Dorion - Jean-Marie Moutquin - Mélanie Levasseur

Fuente: https://link.springer.com/







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