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

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 d...

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Bibliographic Details
Published in:Anatomical record (Hoboken, N.J. : 2007) N.J. : 2007), 2021-09, Vol.304 (9), p.1953-1973
Main Authors: Pagano, Anthony S., Márquez, Samuel, Smith, Christopher M., Laitman, Jeffrey T.
Format: Article
Language:English
Subjects:
Aeration
cartilaginous Eustachian tube
Dentition
development
Developmental stages
dilator tubae
Ear Diseases
Eustachian Tube
Female
Humans
Infant, Newborn
Larynx
Middle ear
Morphology
Neonates
Nose
Otitis Media
Pediatrics
Respiratory System
Respiratory tract diseases
Skull
Teeth
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Summary: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.
ISSN:1932-8486
1932-8494
DOI:10.1002/ar.24600