Middle Ear Function and Pathophysiology in Andean Children Living at High Altitudes

Counter, S. Allen, Leo H. Buchanan, Fernando Ortega, Anthony B. Jacobs, and Göran Laurell. Middle ear function and pathophysiology in Andean children living at high altitudes. High Alt Med Biol. 18:163-170, 2017.-The extent of altitude-related middle ear disorders in children native to high altitudes is unclear. This study examined middle ear pathophysiology in two groups of children living in high-altitude Ecuadorian Andean communities by investigating middle ear pressure (MEP), tympanic membrane compliance (TMC), and ear canal volume (ECV) using tympanometry, and by otological examination. Altitude I Group lived at 2850 m, and Altitude II Group resided at around 4000 m. The two high-altitude groups were compared with a reference group of children residing at sea level. Mean MEP was -3.6 daPa (SD: 39.2), 3.5 daPa (SD: 28.7), and 1.3 daPa (SD: 13.6) for Altitude I Group, Altitude II Group, and the Sea Level Group, respectively. The MEP was not significantly different among the three groups. Mean TMC was 0.63 cm³ (SD: 0.51), 0.60 cm³ (SD: 0.43), and 0.60 cm³ (SD: 0.24) for Altitude I Group, Altitude II Group, and the Sea Level Group, respectively. The TMC was not significantly different among the three groups. Mean ECV was 1.1 (SD: 0.26), 1.2 (SD: 0.26), and 1.0 (SD: 0.23) for Altitude I Group, Altitude II Group, and the Sea Level Group, respectively. The difference in ECV between Altitude I Group and Altitude II Group was significant (p = 0.043), as was the difference between Altitude II Group and the Sea Level Group (p = 0.001). ECV did not differ significantly between Altitude I Group and the Sea Level Group. Otological examination revealed a low incidence of ear canal and middle ear pathology. In conclusion, tympanometric and otological findings did not reveal a high incidence of middle ear pathophysiology in children living at altitudes as high as around 4000 m.