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Effect of upper respiratory tract infection on eustachian tube ventilatory function in the preschool child
Insights
Acute upper respiratory infections (URIs) frequently cause eustachian tube dysfunction in preschoolers, with most abnormalities appearing early in illness. Otitis media with effusion (OME) complicated over 10% of these URIs.
Area of Science:
- Pediatrics
- Otolaryngology
- Infectious Diseases
Background:
- Eustachian tube dysfunction is common in children, often linked to upper respiratory infections (URIs).
- Understanding the tympanometric and microbiologic changes during acute URIs is crucial for pediatric ear health.
- Otitis media with effusion (OME) is a frequent complication requiring further investigation into its induction during URIs.
Purpose of the Study:
- To prospectively evaluate the impact of acute URI on eustachian tube function in preschool children.
- To correlate tympanometric findings with microbiologic data during acute URIs.
- To define the incidence and timing of middle ear pressure abnormalities and OME during URIs.
Main Methods:
- Prospective tympanometric and microbiologic study of 28 preschool children during acute URIs.
- Regular tympanometric assessments to detect middle ear pressure abnormalities.
- Microbiologic sampling to identify respiratory viruses, Streptococcus pneumoniae (Pn), and Haemophilus influenzae (HF).
Main Results:
- Abnormal tympanograms were found in 74.7% of acute URIs, compared to 12.7% in well children.
- Middle ear pressure abnormalities predominantly occurred on days 1 or 2 of illness.
- Otitis media with effusion (OME) complicated 10.1% of URIs; respiratory viruses or Streptococcus pneumoniae were implicated in 40.5%.
Conclusions:
- Acute URIs significantly increase the likelihood of eustachian tube dysfunction in preschoolers.
- Early detection of middle ear abnormalities during URIs is critical for timely intervention.
- Nasopharyngeal colonization with Pn or HF in well children correlates with abnormal middle ear pressure, but not during URI.
Abstract:
A prospective tympanometric and microbiologic study of 28 pre-schoolchildren was undertaken to better define the effect of acute URI on induction of eustachian tube dysfunction. Significant negative middle ear pressure was present in 12.7% of tympanograms from well children. However, abnormal tympanograms were detected during 74.7% of acute URIs. The abnormality was present on day 1 or 2 of illness in the majority of cases; 10.1% of illnesses were complicated by OME. Respiratory viruses or Sp were etiologically implicated in 40.5% of illnesses; isolation rates of Pn and HF from well and ill children were similar. Although colonization of the nasopharynx of well children with Pn or HF was associated with a higher incidence of abnormal middle ear pressure, colonization with Pn or HF during URI did not influence the frequency of tympanogram abnormality.