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- Characterization of middle-ear condition of Oporto daycare children up-to 3 years-old: A cross sectional studyPublication . Tomé, David; Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Costa, Daniel; Ferreira, JoãoObjective The aim of this study was to determine tympanometric values of children who attend Oporto daycare centers and further analyze any relations with host and environmental factors. Methods Cross sectional study in a randomly selected sample of 117 daycare children up-to 3-years old from Oporto. Tympanometric measures were collected. Results Children presented in left ear (LE) a mean peak pressure (PP) of −156.53 daPa and a mean compliance of 0.16 cm3. Right ear (RE) revealed a PP of −145.61 daPa and a compliance of 0.19 cm3. Normal tympanograms (type A) had a lower frequency than abnormal tympanograms (type B and type C). There was a positive association between age and compliance (LE: p = 0.016; RE: p = 0.013) and between the presence of rhinorrhea and PP (LE: p = 0.002; RE: p < 0.05). Abnormal tympanograms were more frequent in Spring (RE: p = 0.009), in younger children (LE: p = 0.03) and in children that had rhinorrhea (LE: p = 0.002; RE: p = 0.044). Healthy children had a mean PP of −125.19 daPa and a mean compliance of 0.21 cm3 in LE and a mean PP of −144.27 daPa and a mean compliance of 0.22 cm3 in RE. Conclusion Tympanometric measures presented in this paper may be applicable to Oporto daycare children up-to 3 years-old. Most of daycare children revealed abnormal tympanograms. Age, rhinorrhea and season influenced children's middle-ear condition.
- Immediate effects of a rhino-pharyngeal clearance protocol in nasal obstruction and middle ear condition of children under 3 years of age with upper respiratory infections: A randomized controlled trialPublication . Alexandrino, Ana Silva; Santos, Rita; Melo, Cristina; Tomé, David; Bastos, José Mesquita; Postiaux, GuyIntroduction and objectives Children up to 2 years old are at high risk of respiratory infections and nasal irrigation is often prescribed. Yet, to date there is no sufficient knowledge about its immediate effects on the nasopharynx and middle ear. Therefore, this study aimed to analyze the effect of a rhino-pharyngeal clearance intervention protocol on nasal obstruction and middle ear condition in children under 3 years of age with URTI. Materials and methods Randomized controlled trial in a day-care centre of Porto, including 44 children randomized to Intervention Group (IG) and Control Group (CG). Nasal auscultation and tympanometry were performed at baseline (M0) as well as after the intervention (M1), which consisted of nasal irrigation (NaCl .9%) followed by a forced nasal inspiration in the IG, and after 30 min of normal activities, in the CG. Results In M1 there was a lower frequency of children classified as having an obstructed nasal sound in the IG when compared to the CG (IG = 33.3%; CG = 68.4%; p = 0.042). We also observed an improvement of mean peak pressure (PP) in the IG (Left ear: M0 = −124daPa; M1 = −92daPa; p = 0.022. Right ear: M0 = −102daPa; M1 = −77daPa; p = 0.021), which was not observed in the CG (Left ear: M0 = −105daPa; M1 = −115daPa; p = 0.485. Right ear: M0 = −105daPa; M1 = −131daPa; p = 0.105). There were no significant results concerning the compliance of the tympanic membrane. Conclusions The rhino-pharyngeal clearance improved the nasal obstruction and PP of the middle ear of children under 3 years of age with URTI.
- Relationship of cranial deformation with nasal obstruction and middle ear function in babies: cross-sectional studyPublication . Gomes, Ana Jacinta; Tavares, Angélica; Silva, Maria Sousa; Silva, Cláudia; Alexandrino, Ana; Varela, Goreti; Mota, António; Tomé, David; Tomé, David; Alexandrino, Ana SilvaThis study aimed to analyse the relationship between cranial deformations (CD), nasal obstruction, and middle ear function in infants up to 12 months of age. A cross-sectional analytical observational study was conducted with a sample of 10 babies (3 females, 7 males) aged between 1 and 7 months. The study utilized quantitative and qualitative methodologies, including the Pediatric Respiratory Severity Scale, tympanometry, and cranial anthropometry using a craniometer. Data were analysed using IBM SPSS Statistics 28, with a 95% confidence interval. Of the 10 participants, 70% had cranial asymmetry index (CAI) alterations, and 60% had cephalic ratio (CR) alterations. Nasal obstruction was observed in 60% of the babies. A significant linear relationship was found between CAI and ear canal volume bilaterally, and between CAI and right ear compliance. Additionally, a significant relationship was observed between CR and ear canal volume. However, no statistically significant relationship was found between CD and nasal obstruction or middle ear pressure values. The study found no direct relationship between cranial deformities and nasal obstruction, although a tendency for nasal obstruction in babies with plagiocephaly and brachycephaly was noted. An increase in CAI was associated with a decrease in ear canal volume and right middle ear compliance, while an increase in CR was related to an increase in ear canal volume. These findings suggest that cranial deformities may impact middle ear function and structure, highlighting the importance of early referral to ENT specialists for infants with CD.