Clinical trial NCT00422929: Eustachian Tube Growth and Development
Official title: Eustachian Tube Growth and Development: Anatomy/Function
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Otitis Media
Keywords: otitis media
ear
acute otitis
middle ear
Eustachian tube
recurrent acute otitis media
chronic otitis media with effusion
no significant history of otitis media
Lead sponsor: University of Pittsburgh
Sponsor class: OTHER
Collaborators: name: National Institute on Deafness and Other Communication Disorders (NIDCD)
First posted: 2007-01-17
Enrollment: 126
Sex: ALL
Minimum age (years): 3
Maximum age (years): 3
Standard ages: CHILD
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Pediatric otolaryngology clinic

Brief summary: This study is to measure over time (from 3 years until 13 years of age) Eustachian tube function (the way the Eustachian tube works) and facial growth in groups of children with two types of middle-ear disease and with little past middle-ear disease. These measures will be used to determine if facial growth is related to improved Eustachian tube function, to see if the better function explains why young children who have middle-ear disease outgrow it as they get older, and to determine if these measures are different for the children in the three groups defined by disease history.

Detailed description: The existing literature documents an important role for the Eustachian tube (ET) in the pathogenesis and/or persistence of otitis media (OM). Cross-sectional studies report a lower prevalence of OM in older children, a better ET pressure-regulating function in older children and age-related differences in ET form, length and width, and the vector orientation of the paratubal musculature. These growth-related changes in ET structural relationships are demonstrably predictive of increasingly more efficient ET function (ETF) and, because the ET and paratubal musculature are intimately related to the cranial base, the vector orientation of the ET system can be reconstructed from osteological or radiographic data. Together, these observations suggest that measurable, age-related changes in ET-paratubal muscle vector relationships are reflected in more efficient ETF and, by consequence, a decreased OM risk. The overall goal of the proposed longitudinal study is to evaluate the validity of this hypothesis.

Eligibility criteria: Inclusion Criteria:

* 3 years of age
* History of middle ear disease must fit into one of the 3 categories of ear history
* With or without patent tympanostomy tubes at time of entry
* Generally good health

Exclusion Criteria:

* Cleft palate or other syndromes predisposing to otitis
* History of significant orthodontic treatment or plan for such
* Cholesteatoma or other past ear surgery other than tubes
* Unable to cooperate for testing

Primary outcomes:
measure: change in Eustachian tube function
timeFrame: 5 years
Secondary outcomes:
measure: change in craniofacial measures
timeFrame: 5 years
Other outcomes:
measure: change in cephalometric variables
timeFrame: 5 years
measure: change in later Eustachian tube function
timeFrame: 11 years
Locations:
city: Pittsburgh
country: United States
facility: ENT Research Center, Children's Hospital of Pittsburgh
state: Pennsylvania
Study officials:
affiliation: University of Pittsburgh
name: Margaretha Casselbrant, MD, PhD
role: STUDY_DIRECTOR
References:
citation: Casselbrant ML, Mandel EM, Seroky JT, Swarts JD, Doyle WJ. A pilot study of the ability of the forced response test to discriminate between 3-year-old children with chronic otitis media with effusion or with recurrent acute otitis media. Acta Otolaryngol. 2011 Nov;131(11):1150-4. doi: 10.3109/00016489.2011.603137. Epub 2011 Aug 17.
citation: Casselbrant ML, Swarts JD, Mandel EM, Doyle WJ. The Cephalic Index is not different among groups of children aged 36-48 months with chronic otitis media with effusion, recurrent acute otitis media and controls. Int J Pediatr Otorhinolaryngol. 2013 Mar;77(3):334-7. doi: 10.1016/j.ijporl.2012.11.002. Epub 2012 Dec 30.
citation: Casselbrant ML, Mandel EM, Seroky JT, Swarts JD, Doyle WJ. The forced-response test does not discriminate ears with different otitis media expressions. Laryngoscope. 2014 Nov;124(11):2619-23. doi: 10.1002/lary.24647. Epub 2014 Aug 11.
citation: Swarts JD, Casselbrant ML, Teixeira MS, Mandel EM, Richert BC, Banks JM, El-Wagaa J, Doyle WJ. Eustachian tube function in young children without a history of otitis media evaluated using a pressure chamber protocol. Acta Otolaryngol. 2014 Jun;134(6):579-87. doi: 10.3109/00016489.2014.882017.
citation: Mandel EM, Casselbrant ML, Richert BC, Teixeira MS, Swarts JD, Doyle WJ. Eustachian Tube Function in 6-Year-Old Children with and without a History of Middle Ear Disease. Otolaryngol Head Neck Surg. 2016 Mar;154(3):502-7. doi: 10.1177/0194599815620149. Epub 2015 Dec 1.
citation: Casselbrant ML, Mandel EM, Doyle WJ. Information on co-morbidities collected by history is useful for assigning Otitis Media risk to children. Int J Pediatr Otorhinolaryngol. 2016 Jun;85:136-40. doi: 10.1016/j.ijporl.2016.03.040. Epub 2016 Apr 11.
citation: Gremba AP, Weinberg SM, Swarts JD, Casselbrant ML. Craniofacial shape in children with and without a positive otitis media history. Int J Pediatr Otorhinolaryngol. 2016 May;84:110-5. doi: 10.1016/j.ijporl.2016.02.029. Epub 2016 Mar 5.