An International Journal of Otorhinolaryngology Clinics

Register      Login

VOLUME 5 , ISSUE 3 ( Number, 2013 ) > List of Articles


Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media

Sunali Khanna, R Rangasayee

Keywords : Eustachian tube,Digital lateral cephalometry,Down syndrome,Otitis media,Conductive hearing Loss

Citation Information : Khanna S, Rangasayee R. Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media. Int J Otorhinolaryngol Clin 2013; 5 (3):133-138.

DOI: 10.5005/jp-journals-10003-1127

Published Online: 01-12-2013

Copyright Statement:  Copyright © 2013; The Author(s).



Cephalometric assessment of Eustachian tube (ET) parameters and audiological evaluation in Down syndrome (DS) and Chronic Otitis Media (COM) and comparison with controls. The ET length, Total Cranial Base (TCB), Posterior Upper Facial Height (PUFH), Maxillary Depth (MD), s-ba (sella-basion) to Palatal Line (PL) and s-ba to ET length were considered.

Materials and methods

The study comprised of 75 subjects of both sexes in the age range of 7 to 20 years. Digital lateral cephalometry was performed for DS, COM and controls (n = 25). Pure tone audiometry (PTA) and immittance audiometry (IA) was performed to assess audiological status.


ET length, PUFH, TCB and MD was found to be significantly reduced in DS and COM. s-ba to PL and s-ba to ET was significantly reduced in DS and COM. The s-ba to PL and s-ba to ET length angle in moderate and severe CHL (Conductive Hearing Loss) was decreased significantly. The s-ba to ET length was significantly decreased in patients with B and C tympanogram.


Aberration in the dimension of the region of the ET can be considered as a predisposing factor for otitis media and conductive hearing loss in DS.

How to cite this article

Khanna S, Rangasayee R. Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media. Int J Otorhinolaryngol Clin 2013;5(3):133-138.

PDF Share
  1. Hearing loss in children with Down syndrome. Int J Pediat Otorhinolarygnol 2001;6(3):199–205.
  2. Advanced therapy for otitis media, Chapter 95. In: Acute Otitis media/Otitis Media with Effusion in Craniofacial Syndromes by Alper et al. (2004),pg 471,BC Decker Publishers.
  3. Age-related morphologic differences in the components of the Eustachian tube/middle ear system. Ann Otol Rhinol Laryngol 1989;98:854–858.
  4. Embryology and anatomy of the Eustachian tube. Arch Otolaryngol 1967;86:503–514.
  5. The nasopharyngeal orifice of the auditory tube: implications for tubal dynamics anatomy. Cleft Palate J 1982;19:119–128.
  6. Growth of the Eustachian tube lumen with age. Am J Otolaryngol 1988;9:195–198.
  7. Association between the eustachian tube and craniofacial skeleton. Int J Pediatric Otorhinolaryngol 2000;53:195–205.
  8. Cephalometric comparison between children with and without Down syndrome. European J Orthodontics 1988;10(1):255–263.
  9. Essentials of Facial Growth. WB Saunders, Philadelphia, PA 1996:291–293.
  10. Otitis media with effusion and craniofacial analysis II: ‘Mastoid middle ear Eustachian tube system’ in children with secretory otitis media. Int J Pediatr Otorhinolaryngol 1995;32:69–76.
  11. Prognostic value of the craniofacial growth and development in children with secretory otitis media. In: Tos M, editor. Proceedings of the Third Extraordinary Conference International Symposium on Recent Advances. In: Otitis Media, Kugler Publication. Amsterdam 1999:81–94.
  12. Analysis of the craniofacial skeleton in cleft children with middle ear effusion. Int J Pediatr Otorhinolaryngol 1999;47:57–70.
  13. Radiological evaluation of children with nasopharyngeal obstruction due to adenoid. Ann Otol Rhinol Laryngol 1999;108:67.
  14. Relationship of Eustachian tube bony landmarks and temporal bone pneumatization. Ann Otol Rhinol Laryngol 1988;97:277–280.
  15. Cranial base relationships of otitis media: a cadaver study. In Toss M, Thomsen J, Peitersen E, editors. Proceedings of the Third International Conference on Cholesteatoma and Eustachian tube function. Plast Reconst Mastoid Surgery, Kugler and Ghedini Publishers, Amsterdam 1989;789–793.
  16. Cranial anatomy and otitis media. Am J Otol 1998;19:558–564.
  17. 4 in Handbook of Clinical Audiology. 5th ed. Katz J Lippincott Williams and Wilkins, 1972, p. 51–52.
  18. Available at:
  19. Physiology, pathophysiology and pathogenesis, In: Otitis media in infants and children. 2nd ed. WB Saunders, Philadelphia, PA, 1995, p. 17–38.
  20. Norms of size and annual increments of the sphenoid bone from four to 16 years. Angle Orthod 1972;42:35–43.
  21. Biennial size norms of eight measures of the temporal bone from 4 to 20 years of age. Angle Ortho 1980;50:107–113.
  22. Discussion, Plast Reconst Surg 1990;85:695–697.
  23. Head shape and middle ear effusion in children. Am J Dis Child 1987;141:375–376.
  24. Growth influence on tubal function. Acta Otolaryngol 1979;87:451–457.
  25. Temporal bone morphometric study on the Eustachian tube and its associated structures in patients with chromosomal aberrations. Ann Otorhinollaryngol 2002;111:722–729.
  26. Developmental anatomy of the supratubal recess in temporal bones from fetuses and children. Am J Otol 1996;17:99–107.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.