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.

咽鼓管的生长和发育：解剖/功能 现有文献记载了咽鼓管（ET）在发病机制和/或 中耳炎 (OM) 持续存在。横断面研究表明，年龄较大的儿童中 OM 患病率较低， 较大儿童的 ET 压力调节功能更好，以及 ET 形状、长度和宽度与年龄相关的差异， 以及输卵管旁肌肉组织的矢量方向。这些与增长相关的 ET 结构变化 关系显然可以预测日益高效的 ET 功能 (F)，并且，因为 ET 和 输卵管旁肌肉组织与颅底密切相关，ET 系统的矢量方向可以是 根据骨学或放射学数据重建。总之，这些观察表明，可测量的， ET-输卵管旁肌肉向量关系中与年龄相关的变化反映在更有效的 ETF 中，并且通过 结果，OM 风险降低。拟议纵向研究的总体目标是评估 这个假设的有效性。我们计划招收 90 名 2 至 3 岁儿童（第 1-30 组，有病史） 复发性急性 OM、有渗出性 OM 病史的 II-30 组以及 III-30 组对照）并进行评估 ETF（每年）并测量颅面形态（通过每年一次的人体测量、每两年一次的头影测量、MRI 4 岁和 6 岁的子集），持续 5 年。颅面测量将用于重建向量 每个孩子的 ET 系统关系，并将与 ETF 结果一起提交给核心 C 分析颅面形态对 ETF 造成限制的转化机制。 这些数据将用于检验以下假设：1) 颅面的某些头影测量 形态学预测 OM 风险增加； 2）与这些措施的对应由非侵入性表示 人体测量； 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基本形式/结构的限制，并且 5) 颅面骨骼的生长发育与更有利的ET/旁管肌相关 向量关系，然后反映在更好的 ETF 测试结果中。在这些儿童的子集中（10 人/组） 因其能够在不使用镇静剂的情况下完成 MRI 测试而被选中，ET-ME 系统的 MRI 将在 4岁和6岁。数据将用于重建系统的功能机制以进行比较 群体之间以及颅面测量产生的各自力学。本项目 代表着将过去的观察性研究转化为纵向临床研究，这将首次 测试那些早期结果提出的可证伪的假设。研究结果可能会导致发展和 应用早期识别 OM“高风险”儿童的方法，以预测病程 以及针对幼儿的替代性、针对患者的干预措施来预防/治愈 OM。