Craniofacial morphology and otitis media with effusion in children
Renata Di Francesco1, Bruno Paulucci, Claudio Nery
1Otolaryngology Department, University of São Paulo, School of Medicine, Sao Paula, Brazil. renatadifran@uol.com.br
Insights
Children with otitis media with effusion show distinct craniofacial differences. These findings in adenoid enlargement cases highlight potential links between facial morphology and middle ear conditions in children.
Area of Science:
- Pediatric Otolaryngology
- Craniofacial Morphology
- Auditory Tube Dysfunction
Background:
- Otitis media with effusion (OME) is common in preschoolers, linked to auditory tube dysfunction.
- Auditory tube development is influenced by craniofacial growth.
- Cephalometric analysis can identify deviations predicting otitis evolution.
Purpose of the Study:
- To investigate craniofacial morphology differences in children with adenoid enlargement.
- Compare children with and without otitis media with effusion (OME).
Main Methods:
- Prospective study of 67 children (5-10 years) with adenoid enlargement.
- Lateral head radiographs analyzed using cephalometric measurements (modified Ricketts analysis).
- Comparison between 33 children with OME (>3 months) and 34 without.
Main Results:
- Children with OME exhibited significant differences in craniofacial morphology.
- Key differing measures included anterior cranial base length, upper facial height, hard palate size, facial depth, facial axis, mandibular length, and pharyngeal airway dimensions.
Conclusions:
- Craniofacial morphology varies between children with adenoid enlargement, with or without otitis media with effusion.
- Specific cephalometric differences may indicate predisposition or association with OME in this population.
Abstract:
Otitis media with effusion (OME) affects 28-38% of pre-school children, and it occurs due to the dysfunction of the auditory tube. Anatomical development of the auditory tube depends on the craniofacial growth and development. Deviations of normal craniofacial morphology and growth using cephalometric studies, may predict the evolution of otitis. Our goal in this paper is to determine if there are differences in craniofacial morphology between children with adenoid enlargement, with and without otitis media with effusion. This is a prospective study in which the sample consisted of 67 children (male and female) from 5 to 10 years old. All patients presented chronic upper airway obstruction due to tonsil and adenoid enlargement (>80% degree of obstruction). Thirty-three patients presented otitis media with effusion, for more than 3 months and 34 did not. The latter composed the control group. Standardized lateral head radiographs were obtained for all subjects. Radiographs were taken with patient positioned by a cephalostat and stayed with mandibles in centric occlusion and lips at rest. Radiographs were digitalized and specific landmarks were identified using a computer program Radiocef 2003, 5th edition. Measurements, angles and lines were taken of the basicranium, maxilla and mandible according to the modified Ricketts analysis. In addition, facial height and facial axis were determined. Children with otitis media with effusion present differences in the morphology of the face, regarding these measures: N-S (anterior cranial base length), N-ANS (upper facial height), ANS-PNS (size of the hard palate), Po-Or.N-Pog (facial depth), Ba-N.Ptm-Gn (facial axis), Go-Me (mandibular length) and Vaia--Vaip (inferior pharyngeal airway).
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