Oral Structural Dysphagia in Children.

Oral causes of dysphagia in infancy may involve the lips, the tongue, or the palate. Whereas ankyloglossia is commonly diagnosed in infants with dysphagia, assessment of the need for surgical intervention may be less straightforward. Tongue size (macroglossia) may be associated with dysphagia as it may cause limitation of movement of the food or milk bolus by the lips or cheeks. Congenital conditions such as cleft lip and palate, micrognathia, or craniofacial microsomia may also be associated with dysphagia. Diagnosis and treatment of these conditions can be improved with the engagement of lactation and feeding experts as well as multidisciplinary craniofacial teams.

Immune modulatory oligonucleotides in the prevention and treatment of OVA-induced eustachian tube dysfunction in rats.

BACKGROUND: Otitis media with effusion (OME) is often associated with allergies. Immune modulatory oligonucleotides (IMO) mediate allergic inflammation and may therefore be efficacious in the treatment of airway inflammation. OBJECTIVE: To evaluate the role of an IMO via transtympanic mucosal application in prevention and treatment of ovalbumin-induced OME. DESIGN: Forty brown Norway rats were divided into control and treatment groups. Eustachian tube dysfunction was evaluated by passive opening pressures, passive closing pressures, active clearance of negative pressure, and mucociliary clearance transit time. RESULTS: Rats who underwent IMO treatment required 50% less pressure to open and close the eustachian tube (P < 0.05) and were able to actively clear 50% more negative pressure than the ovalbumin-control rats (P < 0.001). The treatment rats' mucociliary clearance time was half that of the control group (P < 0.001). CONCLUSION: IMO via transtympanic application can prevent and treat allergy-induced eustachian tube dysfunction in rats. IMO may offer substantial promise in the future management of OME.

Immune modulatory oligonucleotides in prevention of nasal allergen-induced Eustachian tube dysfunction in rats.

OBJECTIVES: Develop a model of nasal allergen-induced Eustachian tube dysfunction (ETD) in a rat and investigate the role of immune modulatory oligonucleotides (IMOs) in the prevention of nasal allergen-induced ETD. STUDY DESIGN AND SETTING: Prospective, randomized study. Brown Norway rats were sensitized to ova albumin (OVA) and randomized to receive pretreatment with IMOs or phosphate-buffered saline. All animals were challenged intranasally with aerosolized OVA. Dynamic measures of Eustachian tube (ET) function were analyzed. RESULTS: Animals that were OVA-sensitized and IMO-pretreated had significantly lower mean passive opening (95% confidence interval [95% CI] 15.0,19.4) and closing (95% CI 4.8,7.8) ET pressures compared with those of (95% CI 24.1,32.7) and (95% CI 12.1,18.8) OVA-sensitized untreated rats, respectively. In addition, the IMO-pretreated animals demonstrated the ability to actively clear a significantly higher proportion of negative pressure (95% CI 0.64,0.96) compared with the untreated animals (95% CI 0.09,0.39). IMO-pretreated animals also demonstrated significantly improved mean mucociliary clearance times in seconds (95% CI 115,195) than those in untreated animals (95% CI 308,668). CONCLUSIONS: Pretreatment with IMOs prevented allergen-induced allergic inflammation around the Eustachian tube (ET) and resulted in improved ventilatory function of the ET compared with sensitized untreated animals. IMOs offer considerable promise in the management of nasal allergic disease as well as otitis media with effusion.