title: The Cephalic Index is not different among groups of children aged 36-48 months with chronic otitis media with effusion, recurrent acute otitis media and controls.
abstract: OBJECTIVE
  The Cephalic Index, an anthropometric measure of head shape, was reported to be different between individuals with and without signs of past or concurrent otitis media (OM). In this study, we compared the Cephalic Index and other measures of head shape among groups of children aged 36-48 months with a documented history of chronic OM with effusion (COME), recurrent acute OM (RAOM) and CONTROLS (few to no OM episodes) to test that hypothesis.
  
  
  METHODS
  In 41 CONTROL, 36 COME and 42 RAOM children, Maximum Head Width, Maximum Head Length and Head Circumference were measured and the Cephalic Index (Head Width/Head Length×100) was calculated. The four measures were compared among the three groups using a General Linear Model that included group, sex and race as factors and age as a covariate.
  
  
  RESULTS
  There were no differences among groups in the Cephalic Index or Head Length. Head Width was significantly smaller in the RAOM when compared to the CONTROL group and Head Circumference was significantly smaller in the RAOM and COME groups when compared to the CONTROL group. For all measures, the distribution of values showed significant overlap among groups.
  
  
  CONCLUSIONS
  These results do not support the hypothesis that the Cephalic Index is different between young children with and without OM, but did document differences in Head Width and Circumference among groups. However, the large overlap in each measure for the three groups suggests that none capture sufficient information on Eustachian tube anatomy to predict disease presentation.
authors.affiliation: Department of Otolaryngology, Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Margaretha L
authors.initials: ML
authors.lastname: Casselbrant
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Swarts
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mandel
authors.forename: William J
authors.initials: WJ
authors.lastname: Doyle
mesh_terms: D000208:Acute Disease; D000886:Anthropometry / Q000379:methods*; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006257:Head / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D010034:Otitis Media with Effusion / Q000503:physiopathology*; D012008:Recurrence