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Renowned pediatric otolaryngologist Dr. Charles Bluestone discusses the impact of evolution on the increased incidence of otitis media in infants and children.

Educational Objectives:

Upon completion of this activity, participants should be able to:

  • Provide evidence that as a consequence of adaptation for bipedalism humans are born at nine months gestation whereas birth should be after 21 months which contributes to the pathogenesis of otitis media in the first year of life.
  • Provide evidence that as a consequence of adaptation for speech as well as facial flattening in humans the pharynx and larynx anatomy changed compared with our immediate ancestors
  • Provide support for the hypothesis that as a consequence of facial flattening and adaptation for speech in humans, as compared with our immediate ancestors, the palatal muscles related to Eustachian tube function changed and may be related to the relatively high incidence of otitis media in humans as compared with other species in nature.

Reading Resources:

  1. Bluestone CD.  Born too soon:  Impact on Pediatric Otolaryngology.  Int J Pediatr Otorhinolaryngol 2005; 69(1):1-8.
  2. Bluestone CD.  Impact of evolution on the Eustachian tube.  Laryngoscope 2008; 118(3):522-527.
  3. Bluestone CD.  Galapagos:  Darwin, Evolution and E.N.T.  Laryngoscope 2009; 119(10):1902-5.
  4. Bluestone CD, Swarts JD.  Human evolutionary history:  consequences for the pathogenesis of otitis media.  Otolaryngol Head Neck Surg 2010; 143(6):739-44.


Dr. Bluestone has no relevant relationships with any entities producing healthcare goods or services.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditsTM. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.075) continuing education units (CEU) which are equivalent to 0.75 contact hours.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 12/26/2012 | Last Modified On: 12/26/2012 | Expires: 12/26/2013

This course has been expired.