Middle ear pressure in preschool age children: influence of respiratory illness, season, and picornavirus or bacteria in the nasopharynx

Abstract

Conclusion. Middle ear pressure was affected by respiratory illness and season; picornavirus (without illness) or pathogenic bacteria in the nasopharynx had no or minor effect. Objective. To examine the effect of respiratory illness, season, and nasopharyngeal microbial flora on middle ear pressure. Subjects and methods. Thirteen children were followed longitudinally with daily recording of respiratory symptoms, weekly tympanometry, and weekly testing of nasal aspirate/washes for Streptococcus pneumoniae, Hemophilus influenzae, Moraxella catarrhalis by culture and for picornavirus by RT-PCR. Results. Abnormal middle ear pressure was present at 47% of 473 weekly visits by 11 preschool age (≤5years) vs 28% of 212 visits by 2 school age children. Symptomatic illness predicted abnormal middle ear pressure (63% of 107 ill visits in preschoolers vs 43% of 366 well visits, p<0.004). Abnormal tympanometry in preschoolers at well visits rose from 26% (80 visits) in summer to 54% (100 visits) in spring (p≤0.03). No increase in abnormal tympanometry occurred during 18 picornavirus infections without illness. The presence of one or more of the bacterial species at ill or well visits had no effect on middle ear pressure except for a 12% increase (p=0.008) in abnormal tympanometry associated with H. influenzae at well visits in preschoolers.

• Streptococcus pneumoniae
• Hemophilus influenzae
• Moraxella catarrhalis
• nasopharyngeal carriage
• middle ear pressure
• tympanometry
• picornavirus