ET Growth and Development: Anatomy/Function

ET 的生长和发育：解剖/功能

• 批准号: 7914271
• 负责人: Margaretha Linnea Casselbrant
• 金额: $ 10.67万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7914271
• 关键词: 3-Dimensional; 4 year old; 6 year old; Acute; Address; Age; Anatomy; Anthropometry; Archives; Biological Preservation; Child; Clinical; Clinical Research; Cross-Sectional Studies; DNA; Data; Development; Disease; Early identification; Elements; Enrollment; Eustachian Tube; Future; Genes; Goals; Growth; Growth and Development function; Health; Image; Individual; Intervention; Lead; Length; Literature; Longitudinal Studies; Low Prevalence; Magnetic Resonance Imaging; Maps; Measurable; Measurement; Measures; Mechanics; Methods; Modeling; Morphology; Muscle; Observational Study; Otitis Media; Otitis Media with Effusion; Pathogenesis; Patients; Pattern; Play; Population; Prevalence; Property; Protocols documentation; Recording of previous events; Recurrence; Recurrent disease; Regulation; Reporting; Research Personnel; Risk; Role; Skeleton; Structure; Subgroup; System; Test Result; Testing; Time; Tissues; Translations; Width; age group; age related; craniofacial; middle ear; outcome forecast; pressure; prevent; reconstruction; skull base; vector

EUSTACHIAN TUBE GROWTH AND DEVELOPMENT: ANATOMY/FUNCTION 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 (F) 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. We plan to enroll a total of 90 children at 2 to 3 years of age (Group 1-30 with a history of recurrent actute OM, Group II-30 with a history of OM with effusion, and Group III-30 control) and to evaluate ETF (yearly) and measure craniofacial morphology (by yearly anthropometry, biyearly cephalometrics, MRI in a subset at age 4 and 6) over a 5 year period. The craniofacial measures will be used to reconstruct vector relationships of the ET system for each child and will be submitted along with the ETF results to Core C for analysis of the translational mechanism underlying the limitations imposed on ETF by craniofacial morphology. These data will be used to test the following hypotheses: 1) certain cephalometric measures of craniofacial morphology predict increased OM risk; 2) correspondences to these measures are represented by non-invasive anthropometric measures; 3) ETF variables discriminate between the different clinical presentations of OM; 4) the mechanical properties of the ET are limited by the underlying form/structure of the craniofacial skeleton, and 5) growth and development of the craniofacial skeleton are associated with more favorable ET/paratubal muscle vector relationships which are then reflected in better ETF test results. In a subset of these children (10/group) selected for their ability to complete MRI testing without sedataion, MRI of the ET-ME system will be obtained at age 4 and 6 years. Data will be used to reconstruct the functional mechanics of the system for comparison among groups and also with the respective mechanics generated by the craniofacial measures. This Project represents the translation of past observational studies into a longitudinal clinical study that will, for the first time, test falsifiable hypotheses suggested by those earlier results. Study results may lead to the development and application of methods for the early identification of children "at risk" for OM, for the prognosis of disease course in young children and for alternative, patient-specific interventions to prevent/cure OM.

Eustachian管的生长和发育：解剖学/功能 现有文献记录了尤斯塔克式管（ET）在发病机理和/或 中耳炎的持久性（OM）。横断面研究报告说，OM患病率较低，年龄较大的儿童，一个 更好的ET压力调节功能在大龄儿童中以及与年龄相关的ET形式，长度和宽度的差异， 以及副肌肉组织的矢量取向。这些与生长有关的ET结构变化 关系明显地预测了越来越有效的ET功能（F），并且因为ET和ET 副肌肉与颅底密切相关，ET系统的矢量取向可以是 从骨学或射线照相数据中重建。总之，这些观察结果表明可测量， ET-Paratubal肌肉载体关系的年龄相关变化反映在更有效的ETF中，并通过 结果，OM风险降低。拟议的纵向研究的总体目标是评估 该假设的有效性。我们计划在2至3岁时总共注册90名儿童（1-30组历史 反复发作的OM，II-30组具有OM史的历史和III-30控制），并评估 ETF（年度）和测量颅面形态（通过年度人体测量法，单年的头足体，MRI 在4岁和6岁时的子集）在5年内。颅面措施将用于重建向量 每个孩子的ET系统的关系，将与ETF结果一起提交给核心C 分析颅面形态对ETF施加的局限性的转化机制。 这些数据将用于检验以下假设：1）颅面的某些头皮测量指标 形态学预测OM风险增加； 2）与这些措施的对应关系由非侵入性表示 人体测量值； 3）ETF变量区分OM的不同临床表现； 4） ET的机械性能受到颅面骨骼的潜在形式/结构的限制，并且 5）颅面骨骼的生长和发育与更有利的ET/副肌肉有关 然后反映在更好的ETF测试结果中的矢量关系。在这些孩子的子集中（10/组） 选择其在没有sedataion的情况下完成MRI测试的能力，将在ET-ME系统的MRI上获得 4岁和6岁。数据将用于重建系统的功能力学以进行比较 在组中以及颅面措施产生的各自的力学中。这个项目 代表了过去的观察性研究转化为纵向临床研究，该研究将首次将 这些早期结果提出的检验可伪造的假设。研究结果可能会导致发展和 适用于早期确定OM“处于风险”的儿童的方法，以预后 在幼儿和替代性，特定于患者的干预措施中，以预防/治愈OM。