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[The size of the mastoid pneumatization and otitis media with effusion in children]
Insights
Chronic middle ear inflammation can suppress mastoid air cell growth. This study suggests X-ray imaging can reveal past ear infections in children by assessing this suppressed pneumatization.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Developmental Biology
Background:
- Chronic middle ear inflammatory conditions are linked to suppressed pneumatization of air cells.
- Previous studies in pigs demonstrated that inflammation inhibits pneumatization, with severity correlating to inflammation's degree and duration.
- Normal pneumatization in pigs and human fetuses involves similar bone metabolism during the mastoid growth phase.
Purpose of the Study:
- To investigate the relationship between chronic otitis media and suppressed pneumatization in humans.
- To establish if imaging can reveal past middle ear pathologies based on pneumatization status.
Main Methods:
- Histological study of 100 human fetal sides (16-36 weeks gestation) to examine normal pneumatization.
- Experimental studies in pigs to model normal and suppressed pneumatization processes.
- Comparison of bone metabolism in pig and human fetal pneumatization.
Main Results:
- Normal pneumatization occurs during the mastoid growth period (0-6 months in pigs, 0-15 years in humans).
- Persistent otitis inflammation, such as otitis media with effusion, likely suppresses cellulae growth in humans.
- The degree of pneumatization suppression correlates with the severity and duration of middle ear inflammation during development.
Conclusions:
- In humans, suppressed pneumatization is strongly associated with early-life otitic inflammation.
- X-ray imaging may allow for the assessment of previous middle ear pathology in children by evaluating the extent of pneumatization suppression.
Abstract:
It is generally believed that a cause and effect relationship exists between chronic middle ear inflammatory conditions and suppressed growth of the pneumatized cellulae. We already demonstrated the normal process of pneumatization and the suppressive process of pneumatization in experimental studies using pigs. In that study, the process of suppression of the pneumatization was caused by the continuous inflammatory changes of the epithelium of the middle ear cavity, and the degree of the suppression of the pneumatization was caused by the degree and duration of the air cavity's inflammatory condition at the growing stage of the mastoid process. We also carried out the histological study of the normal process of pneumatization using 100 sides of human fetuses between 16th and 36th week of pregnancy. In these studies the bone metabolisms which were found in the normal processes of pneumatization in pigs and human fetuses were same, and the normal pneumatization occurred at the growing stage of the mastoid process. This growing period of the mastoid is from 0 to 6 months after birth in pigs, and 0 to 15 years in humans. So in humans, we can infer that the suppression of the growth of the cellulae is closely related to a persistent state of otitic inflammation like an otitis media with effusion in the early stages of growth. From these studies, in children who have otitis media with effusion, it will be possible to realize the previous middle ear pathology by the degree of the suppression of pneumatization on x-ray film.(ABSTRACT TRUNCATED AT 250 WORDS)