suture restriction of the temporal bone as a risk factor for acute otitis media in children cohort study缝合限制颞骨的队列研究儿童急性中耳炎的风险因素.pdf

Morin et al. BMC Pediatrics 2012, 12:181 /1471-2431/12/181 RESEARCH ARTICLE Open Access Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study 1* 2 3,4 1 Chantal Morin , Dominique Dorion , Jean-Marie Moutquin and Mélanie Levasseur 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