Fricano Ellen E, Gremba Allison P, Teixeira Miriam S, Swarts J Douglas, Alper Cuneyt M
College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766, USA.
Doctor of Physical Therapy Program, School of Natural and Health Sciences, Seton Hill University, Greensburg, PA 15601, USA.
Bioengineering (Basel). 2023 Sep 23;10(10):1115. doi: 10.3390/bioengineering10101115.
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 ( < 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.
中耳炎（OM）是儿童期最常见的疾病之一。长期以来，人们一直推测两岁以下的儿童由于咽鼓管（ET）解剖结构的差异，包括咽鼓管的角度，易患中耳炎。儿童后期患中耳炎的情况较少见，但确实会发生，这就引出了一个问题，即咽鼓管的形状差异是否在后期中耳炎的发生中持续存在？为了回答这个问题，研究采用了一种新方法，即对从MRI数据中获取的地标点进行几何和形态测量形状分析。2011年至2015年期间，对16名儿童（5名对照、3名慢性中耳炎、8名复发性急性中耳炎）进行了MRI扫描。分析了代表咽鼓管、颅底和腭部形状的16个地标点。普氏方差分析结果表明，中耳炎组和对照组之间咽鼓管的形状存在显著差异（<0.01）。中耳炎组与对照组之间的形状差异在于腭帆张肌（TVP）肌肉的内侧和低位附着点、后方和高位的咽鼓管圆枕以及向前突出的腭部。这些结果支持了先前的研究发现，即相对水平的咽鼓管与易患中耳炎有关。本研究采用了一种新方法来检查患有和未患有中耳炎的儿童的解剖差异。首先，该数据集的独特之处在于它包括了确诊为中耳炎的儿童的MRI扫描。其次，在颅面解剖学中耳炎研究中使用MRI扫描是新颖的，并且允许收集软组织地标点并可视化软组织结构。第三，几何形态测量形状分析是一种统计方法，它可以捕捉形状差异，与先前研究颅面解剖学的中耳炎研究中使用的更传统的线性和角度测量相比，它能更全面地呈现整个地标点集合内细微变化的情况。
