Abstract
Otitis media is the leading cause of hearing loss in children. It is commonly associated with fluid in the ear, which can result in up to 45 dB of hearing loss for extended periods of time during a child’s most important developmental years. Accurate assessment of middle ear effusions is an important part of understanding otitis media. Current technologies used to diagnose otitis media with effusion are pneumatic otoscopy, tympanometry, and acoustic reflectometry. While all of these techniques can reasonably diagnose the presence of an effusion, they provide limited information about the infection present behind the tympanic membrane.
We have developed a technique based on low-coherence interferometry—a non-invasive optical ranging technique capable of sensing depth-resolved microscopic scattering features through the eardrum—to quantify eardrum thickness and integrity, as well as detect any effusion, purulence, or biofilm behind the tympanic membrane. In this manuscript, the technique is coupled with a pneumatic otoscope to measure minute deflections of the tympanic membrane from insufflation pressure stimuli. This results in quantitative measurements of tympanic membrane mobility, which may be used to gain a better understanding of the impact of infection on the membrane dynamics. A small pilot study of 15 subjects demonstrates the ability of pneumatic low-coherence interferometry to quantitatively differentiate normal ears from ears with effusions present. Analysis of the strengths and weaknesses of the technique, as well as focus areas of future research, is also discussed.
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Acknowledgements
The authors thank Darold Spillman from the Beckman Institute for the helpful discussions, Deveine Toney from the Carle Research office for the study coordination, nursing staff from the otolaryngology department at Carle Foundation Hospital for the clinical support, and Eric Chaney from the Beckman Institute for the IRB support. This work was supported by a Bioengineering Research Partnership grant (R01 EB013723) from the NIH/NIBIB, the National Science Foundation (CBET 14-45111), as well as a grant from the University of Illinois Proof-of-Concept Fund.
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R.L.S., R.M.N, and S.A.B. have a financial interest in PhotoniCare, Inc., a company commercializing technology related to this manuscript. PhotoniCare did not, however, sponsor this research.
Subjects for this study were recruited and enrolled under a protocol approved by the Institutional Review Boards (IRB) of the University of Illinois at Urbana-Champaign and Carle Foundation Hospital in Urbana, IL. Patients were recruited and imaged in the otolaryngology clinic at Carle Foundation Hospital, Urbana, Illinois.
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Shelton, R.L..., Nolan, R.M., Monroy, G.L. et al. Quantitative Pneumatic Otoscopy Using a Light-Based Ranging Technique. JARO 18, 555–568 (2017). https://doi.org/10.1007/s10162-017-0629-5
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DOI: https://doi.org/10.1007/s10162-017-0629-5