School of Medicine Researcher Pinpoints Causes of Infant Ear Infections

An estimated 80 percent of all children acquire one or more ear infections during their youth, and especially between the ages of 6 months and 1 year of age. This high rate of infection has been attributed to a short, horizontal cartilaginous Eustachian tube (CET) connecting the middle ear cavity lying behind the eardrum to the postnasal airway.

The normal function of the tube is to ventilate and drain fluid from the middle ear where bacterial and viral infections can occur. But this process is hampered among infants and young children who have a less efficient tubal system than those of adults.

Now a team including a Hackensack Meridian School of Medicine scientist and colleagues have used 3-D coordinate-based geometric analysis of skull development to determine that uneven growth among upper airway structures at especially young ages allows the opportunity for the infections to arise, as they report in The Anatomical Record, a Wiley journal.

“This paper may have some impact on the world of pediatric ENT medicine,” said Anthony Pagano, Ph.D., an assistant professor in the Department of Medical Sciences at the School and lead author of the study.

Working with colleagues from the State University of New York Downstate Health Sciences University (Samuel Máquez), the CUNY Graduate Center (Christopher Smith) and the Icahn School of Medicine at Mount Sinai (Jeffrey Laitman), Pagano and colleagues investigate the minute morphological differences in ages of children spanning from birth up to 12 years.

The 160 skulls analyzed for this study are from the Spencer R. Atkinson Collection of the University of the Pacific School of Dentistry.

The dimensions were mapped, focusing especially on 33 anatomical landmarks to assess digitally the different rates of growth among the bony boundaries of the auditory tube and postnasal airway.

They focused on early growth of the CET and the muscle responsible for opening it, the dilator tubae (DT), using a developmental series of dry crania to reconstruct their morphology.

What they found in the comparisons: the muscle was growing too fast for the tube to keep up – leaving an imbalance which could cause the increased infections in the latter half of the first year of life via an inadequate dilatory mechanism.

“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,” they conclude.

To read more about the study, visit the paper online here.