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Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study.

Abstract

BACKGROUND

Eustachian 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.

METHODS

Using 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.

RESULTS

Severe 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).

CONCLUSIONS

The 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.

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  • Authors+Show Affiliations

    ,

    School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12e Avenue nord, Sherbrooke, QC J1H 5N4, Canada. Chantal.Morin@USherbrooke.ca

    , ,

    Source

    BMC pediatrics 12: 2012 Nov 20 pg 181

    MeSH

    Acute Disease
    Cohort Studies
    Cranial Sutures
    Female
    Humans
    Infant
    Linear Models
    Male
    Odds Ratio
    Otitis Media
    Prospective Studies
    Risk Factors
    Single-Blind Method
    Temporal Bone

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23167940

    Citation

    Morin, Chantal, et al. "Suture Restriction of the Temporal Bone as a Risk Factor for Acute Otitis Media in Children: Cohort Study." BMC Pediatrics, vol. 12, 2012, p. 181.
    Morin C, Dorion D, Moutquin JM, et al. Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study. BMC Pediatr. 2012;12:181.
    Morin, C., Dorion, D., Moutquin, J. M., & Levasseur, M. (2012). Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study. BMC Pediatrics, 12, p. 181. doi:10.1186/1471-2431-12-181.
    Morin C, et al. Suture Restriction of the Temporal Bone as a Risk Factor for Acute Otitis Media in Children: Cohort Study. BMC Pediatr. 2012 Nov 20;12:181. PubMed PMID: 23167940.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study. AU - Morin,Chantal, AU - Dorion,Dominique, AU - Moutquin,Jean-Marie, AU - Levasseur,Mélanie, Y1 - 2012/11/20/ PY - 2012/06/25/received PY - 2012/11/18/accepted PY - 2012/11/22/entrez PY - 2012/11/22/pubmed PY - 2013/5/17/medline SP - 181 EP - 181 JF - BMC pediatrics JO - BMC Pediatr VL - 12 N2 - BACKGROUND: Eustachian 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. METHODS: Using 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. RESULTS: Severe 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). CONCLUSIONS: The 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. SN - 1471-2431 UR - https://www.unboundmedicine.com/medline/citation/23167940/Suture_restriction_of_the_temporal_bone_as_a_risk_factor_for_acute_otitis_media_in_children:_cohort_study_ L2 - https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-12-181 DB - PRIME DP - Unbound Medicine ER -