Cranial Indicators Identified for Peak Incidence of Otitis Media

Abstract

Acute otitis media (AOM) is one of the most common pediatric conditions worldwide. Peak age of occurrence for AOM has been identified within the first postnatal year and it remains frequent until approximately six postnatal years. Morphological differences between adults and infants in the cartilaginous Eustachian tube (CET) and associated structures may be responsible for development of this disease yet few have investigated normal growth trajectories. We tested hypotheses on coincidence of skeletal growth changes and known ages of peak AOM occurrence. Growth was divided into five dental eruption stages ranging from edentulous neonates (Stage 1) to adults with erupted third maxillary molars (Stage 5). A total of 32 three-dimensional landmarks were used and Generalized Procrustes Analysis was performed. Next, we performed principal components analysis and calculated univariate measures. It was found that growth change in Stage 1 was the most rapid and comprised the largest amount of overall growth in upper respiratory tract proportions (where time is represented by the natural logarithmic transformation of centroid size). The analysis of univariate measures showed that Stage 1 humans did indeed possess the relatively shortest and most horizontally oriented CET's with the greatest amount of growth change occurring at the transition to Stage 2 (eruption of deciduous dentition at five postnatal months, commencing peak AOM incidence) and ceasing by Stage 3 (approximately six postnatal years). Skeletal indicators appear related to peak ages of AOM incidence and may contribute to understanding of a nearly ubiquitous human disease. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 300:1721-1740, 2017. © 2017 Wiley Periodicals, Inc.

Reconstructing the Neanderthal Eustachian Tube: New Insights on Disease Susceptibility, Fitness Cost, and Extinction

“…By this definition, adulthood is reached upon eruption of M 3 . These growth stages have been shown to correspond with major developmental changes in cranial shape (Hellman, ; Ashton, ; Laitman et al, ; Bolter and Zihlman, ; Pagano et al, ).…”

“…The baseline comparator for the Neanderthal sample was an extant human growth series ranging from newborns to adults (Pagano and Laitman, 2015;Pagano et al, 2017). Much of the materials and assessment methods has been published previously in Pagano et al (2017) and will be summarized here.…”

“…The baseline comparator for the Neanderthal sample was an extant human growth series ranging from newborns to adults (Pagano and Laitman, ; Pagano et al, ). Much of the materials and assessment methods has been published previously in Pagano et al () and will be summarized here. Adult humans were sampled primarily from the collection of the Division of Anthropology, American Museum of Natural History (New York, NY), and nonadults from the Spencer R. Atkinson Collection of the University of the Pacific School of Dentistry (San Francisco, CA; Table ).…”

“…It is comprised of both an osseous canal within the temporal bone and a cartilaginous Eustachian tube (CET) spanning between its orifices on the temporal bone laterally and pharyngeal wall medially. The morphology and proper functioning of the CET is intimately tied to developmental and evolutionary changes among the boundaries of the nasopharynx and nasal cavity (Bluestone, ; Bluestone and Swarts, ; Bluestone et al, ; Pagano et al, ). Despite its obvious importance, the anatomy and functional of the CET among human ancestors remains largely unknown.…”

“…The CET is passively closed to maintain its protective function but is pulled open by the dilator tubae arm of the tensor veli palatini muscle during instances of swallowing and yawning (Toynbee, ; Gannon et al, ; Bluestone, ). Among infants and young children under age six (Pagano et al, ), a more horizontally oriented CET allows easier access to the middle ear by infectious agents suspended in postnasal mucus, resulting in middle ear infection (otitis media [OM]; Proctor, ; Bluestone, , ). OM is one of the most common global diseases (de Antonio et al, ), ranging from benign otitis media with effusion (OME; see Doyle, ) to acute otitis media (AOM; middle ear effusions in the presence of acute viral or bacterial infection).…”