%0 Journal Article
%T Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study
%A Chantal Morin
%A Dominique Dorion
%A Jean-Marie Moutquin
%A M¨¦lanie Levasseur
%J BMC Pediatrics
%D 2012
%I BioMed Central
%R 10.1186/1471-2431-12-181
%X Using a prospective cohort design, 64 children aged 6 to 18 months without prior history of AOM were followed during the cold season (September 2009 to April 2010). Temporal bone status (categorized as with or without severe suture restriction) was evaluated using palpation and a cranial bone mobility test. Information about potential baseline confounders and risk factors for AOM (gender, age, birth weight, gestational age, use of pacifier, daycare attendance, presence of siblings, low socioeconomic status, breastfeeding ¡Ý 6 months, parental smoking and history of upper respiratory tract infection) were also collected. Occurrence of AOM diagnosed by physicians blinded to temporal bone status was the main outcome. Data were analyzed using hierarchical linear and nonlinear (multilevel) models.Severe suture restriction of the temporal bone was identified in 23 children (35.9%). At least one AOM episode was diagnosed in 14 (48.3%) of the ears associated with temporal bones previously identified as having severe suture restriction and in 28 (28.3%) of those without severe suture restriction. Higher risk for AOM was explained by severe suture restriction of the temporal bone (adjusted relative risk (RR), 2.26, 95% CI 1.43 to 2.91, p<.01), pacifier use (RR, 2.59, 95% CI 1.51 to 3.22, p<.01) and younger age (RR, 0.22, 95% CI 0.10 to 0.52, p=.001).The study results indicate that severe suture restriction of the temporal bone is a risk factor for AOM in young children. Subsequent intervention studies are needed to determine if this mechanical risk factor can be modified in young children.Acute otitis media (AOM) is one of the most common childhood infections [1], with important societal and individual consequences. From 1995 to 2003, AOM incidence rates in children under 2 years of age increased by 46%, while antibiotic prescription rates went up by 45% [2]. This situation not only contributes to antibiotic resistance but also creates a significant financial and social burden
%K Acute otitis media
%K Temporal bone
%K Children
%K Eustachian tube
%K Risk factor
%K Cohort
%K Cranial suture
%K Osteopathy
%U http://www.biomedcentral.com/1471-2431/12/181