Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report.

Edoardo Bernkopf,Giulia Bernkopf,Luciano Giacomelli,Giovanni Carlo De Vincentis,Francesco Macrì,Andrea Lovato,Cosimo De Filippis

doi:10.1155/2016/2473059

Abstract

Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods. The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p < 0.0001) and multivariate analysis (p = 0.001). Conclusions. RAOM showed better outcomes in children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction.

Highlights

Otitis media with its different clinical forms (i.e., acute otitis media (AOM), otitis media with effusion, chronic purulent otitis, and chronic otitis with cholesteatoma) has an important incidence in pediatric population
Recurrent Acute Otitis Media (RAOM) is a clinical form defined as the recurrence of 3 AOM episodes within 6 months or 4 episodes during a year
Adenoid hypertrophy [6], allergic rhinitis [7], and anatomic anomalies of the nasal pyramid [8] play a role in the pathogenesis of otitis media affecting Eustachian tube function

Summary

Introduction

Otitis media with its different clinical forms (i.e., acute otitis media (AOM), otitis media with effusion, chronic purulent otitis, and chronic otitis with cholesteatoma) has an important incidence in pediatric population. Recurrent Acute Otitis Media (RAOM) is a clinical form defined as the recurrence of 3 AOM episodes within 6 months or 4 episodes during a year. Adenoid hypertrophy [6], allergic rhinitis [7], and anatomic anomalies of the nasal pyramid [8] play a role in the pathogenesis of otitis media affecting Eustachian tube function. Ventilation tubes should be considered in children with RAOM with middle ear effusion, or in the presence of conductive hearing loss [10]. The treatment for dental malocclusion is based largely on mandibular repositioning devices [13]. Dental malocclusion affecting TMJ may be involved in Eustachian tube function and in the pathogenesis of RAOM.

Materials and Methods

Results

Discussion

Conclusions