Craniofacial shape in children with and without a positive otitis media history

Gremba, Allison P.; Weinberg, Seth M.; Swarts, J. Douglas; Casselbrant, Margaretha L.

doi:10.1016/j.ijporl.2016.02.029

Cited by 9 publications

(9 citation statements)

References 47 publications

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“…Most recently, Gremba et al () performed a two‐dimensional geometric morphometric analysis of lateral X‐rays of children with and without otitis media at four (41 normal children and 38 with otitits media) and six years of age (27 normal and 25 with otitits media), comparing their bony airways via principal components analysis and discriminant function. It was found that individuals in the four year‐old group with otitis media differed significantly ( P < 0.035) in shape from nonsymptomatic children of the same age.…”

Section: Anatomical Backgroundmentioning

confidence: 99%

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Cranial Indicators Identified for Peak Incidence of Otitis Media

Pagano

Wang

Yuan

et al. 2017

The Anatomical Record

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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.

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Section: Anatomical Backgroundmentioning

confidence: 99%

“…None of these differences were found among the six year‐old sample of children with and without otitis media. Despite these interesting results, Gremba et al () collected data from lateral plain film radiographs, which does not account for the impact of mediolateral growth.…”

Section: Anatomical Backgroundmentioning

confidence: 99%

Cranial Indicators Identified for Peak Incidence of Otitis Media

Pagano

Wang

Yuan

et al. 2017

The Anatomical Record

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“…The collection was chosen as it is one of the largest available that spans in age from birth to the eruption of the first molar. Our growth series was designed to correspond to the time of peak OM incidence from birth until approximately 6 years of age (Gremba et al, 2016; Pagano et al, 2017; Takasaki et al, 2007), after which there is an associated clinical decline of OM occurrence (Casselbrant et al, 1986). The crania were divided into separate age groups using the dental eruption patterns from both the upper and lower jaw (see Table 2) applying the protocol of Moorrees, Fanning, and Hunt (1963) for eruption of the deciduous dentition.…”

Section: Methodsmentioning

confidence: 99%

“…The first of the cephalometric studies to utilize a geometric morphometric approach was Gremba and colleagues, (Gremba, Weinberg, Swarts, & Casselbrant, 2016) who analyzed shape differences among cohorts of 4‐year‐old children with and without recurrent OM and 6‐year‐old children with and without recurrent OM. Two‐dimensional bony landmarks distributed around the facial skeleton, cranial base, and mandible were collected from lateral radiographs.…”

Section: Introductionmentioning

confidence: 99%

Identification of critical windows in early development of human upper respiratory tract and middle ear disease

Pagano

Márquez

Smith

et al. 2021

The Anatomical Record

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Otitis media (OM) or middle ear disease is a prevalent pediatric condition generally related to early growth of the cartilaginous Eustachian tube (CET). This study used a developmental series of dry crania to reconstruct CET and dilator tubae (DT, the muscle opening the CET) morphology. Timing and directionality of CET and upper respiratory tract (URT) growth were investigated. Traditional and 3D geometric morphometrics (GM) were used to assess bony landmarks on the crania. The series was divided using dental eruption into seven growth stages ranging from before eruption of deciduous dentition (approximately the first 6 postnatal months) to eruption of the first permanent maxillary molar (after approximately 6 years). Bony endpoints of the CET and DT were used to calculate their morphology. GM analysis showed substantial shape differences between newborns, early infants, and all later developmental stages. Univariate measures showed the largest growth change between birth and 6 months. Subsequently, CET morphology changed little in the latter half of year 1, instead maturing gradually until approximately 3 years whereas DT relative length and orientation finish growth by the end of year 1. Incongruence in slower CET growth and faster DT growth could impact CET function between 6 and 12 months and be a contributing factor of OM. Tubal aeration may improve after this time when both CET and DT morphology mature, coinciding with clinically reported drop‐off in ear infections.

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“…The ET, located deep within the head, is particularly challenging to assess and visualize, even with modern imaging technology, which perhaps explains the relatively few studies that directly compare its shape in groups with known diagnoses. Methodologies for evaluating the shape of this structure range from two-dimensional lateral radiographs [22] to three-dimensional quantification from dry skulls and CT imaging [23][24][25][26][27][28]. Past literature suggests that the angle of the ET changes dramatically from infancy to adulthood and that shape changes in the basicranium and nasopharynx coincide with the timing of peak OM incidence.…”

Section: Introductionmentioning

confidence: 99%

Using Geometric Morphometric Analysis of Magnetic Resonance Imaging to Assess the Anatomy of the Eustachian Tube in Children with and without Otitis Media

Fricano,

Gremba,

Teixeira

et al. 2023

Bioengineering

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Otitis media (OM) is among the most common of childhood illnesses. It has long been hypothesized that children under age two are predisposed to OM due to differences in the anatomy of the Eustachian tube (ET), including the angle of the ET. OM in later childhood is less common but does occur, begging the question, are there shape differences in the ET that persist underlying later occurrences of OM? To answer this question, a novel method, which applied geometric and morphometric shape analysis to landmarks obtained from MRI data, was used. MRI scans were performed on 16 children (5 control, 3 cOME, and 8 rAOM) between 2011 and 2015. Sixteen landmarks representing the shape of the ET, cranial base, and palate were analyzed. The results of a Procrustes ANOVA indicate that the shape of the ET varies significantly (p < 0.01) between the OM and control groups. The shape differences between the OM group and the control are a medial and low attachment site of the tensor veli palatini (TVP) muscle, a posterior and high torus tubarius, and an anteriorly projected palate. These results support previous findings that a relatively horizontal ET is associated with a predisposition for OM. This study used a novel approach to examine anatomical differences in children with and without OM. First, the data set is unique in that it includes MRI scans of children with a confirmed OM diagnosis. Second, the use of MRI scans in craniofacial anatomy OM research is novel and allows for the collection of soft tissue landmarks and the visualization of soft tissue structures. Third, geometric morphometric shape analysis is a statistical method that captures shape differences, offering a more universal picture of nuanced changes within the entire set of landmarks, in contrast to more traditional linear and angular measurements used in prior OM studies examining craniofacial anatomy.

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Craniofacial shape in children with and without a positive otitis media history

Cited by 9 publications

References 47 publications

Cranial Indicators Identified for Peak Incidence of Otitis Media

Cranial Indicators Identified for Peak Incidence of Otitis Media

Identification of critical windows in early development of human upper respiratory tract and middle ear disease

Using Geometric Morphometric Analysis of Magnetic Resonance Imaging to Assess the Anatomy of the Eustachian Tube in Children with and without Otitis Media

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