International Journal of Pediatric Otorhinolaryngology
Chorda tympani nerve function in children: Relationship to otitis media and body mass index☆
Introduction
The reported prevalence of recurrent acute otitis media (AOM) in children has been increasing, despite the development of antibiotics [1]. In developed countries, it is the most common indication for antibiotics and surgery in young children [2]. Concurrently, in North America, the incidence of childhood obesity has also been increasing. Current data using World Health Organization body mass index (BMI) criteria shows that 22% of Canadian children are overweight and another 13% are obese [3]. Interestingly, a relationship between AOM and BMI was recently reported [4]: adults who had experienced moderate to severe AOM as children were more likely to be obese. The authors of this study postulated that the chorda tympani nerve (CTN) may play a role in the apparent relationship between childhood OM and obesity [4].
There is some anatomical support for this idea. The CTN is a branch of the seventh cranial nerve that traverses the middle ear space and conveys taste sensation from the anterior two-thirds of the tongue to the brain. It has been hypothesized that chronic or repeated episodes of inflammation, as may occur in the case of chronic or acute OM, may injure the CTN. Indeed, histopathological studies have confirmed that characteristic abnormalities are found in the CTNs of patients with chronic OM [5]. It has been suggested that this inflammation may result in altered taste sensation which in turn may impact food choices and eating habits, ultimately leading to obesity [4].
The hypothesis that OM can impact CTN function and alter taste sensation in children is intriguing. However, it has never been directly tested. Using electrogustometry (EGM), a surrogate measure of CTN function, we sought to definitively determine whether a detectable relationship exists between AOM and CTN function in children.
Section snippets
Materials and methods
One hundred and forty-two consecutive pediatric patients aged 5–18 years who were seen in the outpatient otolaryngology clinic between May and August 2009 were recruited for participation in this study. Research Ethics Board approval was obtained. Patient and parents were consented for participation and chart reviews were conducted to extract the following information: age, gender, history of ear surgery, past medical history, and history of any issues or concerns with taste function.
Results
Patient demographics are presented in Table 1.
EGM thresholds were obtained for all patients in each of the three AOM groups (zero, 1–5, and greater than 5 prior episodes of AOM). For each patient, left and right thresholds showed a statistically significant correlation (R = 0.71, p < 0.0001). Lowest (i.e., most sensitive perception of taste) thresholds for each patient were therefore used in subsequent analyses as planned in the study protocol. There was no difference in thresholds between patients
Discussion
A relationship between OM and pediatric obesity has recently been reported [11]. That study involved the measurement of BMI in two groups of children: those who underwent ventilation tube insertion for OM with effusion (OME), and control patients who had no history of OME. It was found that BMI was significantly higher in the OME patient group [11]. Similarly, data presented at the 2008 American Psychological Association and American Chemical Society meetings gained widespread media attention
Conclusion
This study is the first to directly test the hypothesis that CTN function is affected by AOM in children. EGM thresholds, obtained as a surrogate of CTN function, did not vary significantly with history of AOM. In contrast to previous reports, there was no relationship found between history of AOM and obesity in this pediatric population. If a relationship between AOM and obesity does exist, it does not appear to be explained by measurable alteration in CTN function.
Conflict of interest
None.
Acknowledgement
We would like to acknowledge Jerome Valero for excellent database and technical support.
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Associations between Otitis media, taste sensitivity and adiposity: Two studies across childhood
2019, Physiology and BehaviorCitation Excerpt :Histopathological changes to CT and loss of the nerve function have been reported in a sample of 107 adults with chronic OM [15]. Conversely, another study found no differences CT function among 5–18 year olds with a history of OM [11]. Consistent with the CT impairment hypothesis, it has been reported that children with recurrent OM lost the ability to taste quinine on the anterior portion of the tongue and showed enhanced responses to citric acid [16], while adults exposed to OM showed both reduction and enhancement of different tastes, including bitter, salty, sweet and sour [14,17].
Otitis media exposure associates with dietary preference and adiposity: A community-based observational study of at-risk preschoolers
2012, Physiology and BehaviorCitation Excerpt :History of recurrent OM treated with tympanostomy tube treatment was associated with increased risk of being overweight in children up to the age of 2 [23] and children from 2 to 7 years old [24]. In older children, exposure to OM has been linked to overweight risk from a small community-based study [25] and unpublished preliminary data analysis of a nationally-representative longitudinal sample [26], although the relationship was not found in children recruited from an otolaryngology practice [17]. Based on survey responses, adults with greater history of OM also reported greater liking for high-fat foods and were heavier [27].
Otitis media and associations with overweight status in toddlers
2011, Physiology and BehaviorCitation Excerpt :However, this study nor published literature, has shown that this taste change is the cause for increased weight gain. More recently, Seaberg et al. directly measured CT function in children (ages 5–18 years) with and without a previous history of AOM to determine relationship to BMI [39]. Using electrogustometric thresholds as a measure of CT function, they found no relationship with nerve function and OM history as well as no association with BMI.
Causal Relationship Between Body Mass Index and Risk of Otitis Media with Effusion in Children: A Mendelian Randomization Study
2024, Indian Journal of Otolaryngology and Head and Neck SurgeryUnilateral Increase of Gustatory Thresholds in Acute Otitis Media: A Pilot Study
2023, Journal of International Advanced OtologyOtitis media and obesity—an unusual relationship in children
2021, Healthcare (Switzerland)
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This paper was presented at the Society for Ear, Nose and Throat Advances in Children Annual Meeting in Salt Lake City, Utah, USA, December 3–6, 2009.