Evidence for a relationship between head shape and prevalence of middle ear effusion in children

Abstract

AbstractTo determine if there is an association between head shape type (brachycephaly, mesocephaly, and dolichocephaly) and prevalence of middle ear effusions, we performed tympanometry and head measurements on 203 children who were enrolling in kindergarten and who were 4 or 5 years old. Maximum head length and head breadth were measured using anthropometric spreading calipers, and the cephalic index (CI) was calculated for each child (head width/head length × 100). Children with a CI > 1 standard deviation (SD) from the mean were classified as brachycephalic, those with a CI < 1 SD as dolichocephalic, and the remainder as mesocephalic.The overall distribution of flat tympanograms (indicative of middle ear effusions) by head shape type was unlikely to have occurred by chance (X2(2) = 6.2; P < 0.05). Brachycephalic children had a significantly greater prevalence (39%) of flat tympanograms, than did mesocephalic children (19%; P = 0. 015). There was a trend toward more dolichocephalic children having effusions (29%) than mesocephalic children (19%), but the difference was not significant (P = 0.24). Neither race nor sex affected the relationship between brachycephaly and middle ear effusions. Brachycephaly is a physical finding associated with flat tympanograms and, therefore, middle ear effusions in preschool children. © 1994 Wiley‐Liss, Inc.