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Noninvasive depth‐resolved optical measurements of the tympanic membrane and middle ear for differentiating otitis media
Author(s) -
Monroy Guillermo L.,
Shelton Ryan L.,
Nolan Ryan M.,
Nguyen Cac T.,
Novak Michael A.,
Hill Malcolm C.,
McCormick Daniel T.,
Boppart Stephen A.
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25141
Subject(s) - medicine , middle ear , optical coherence tomography , acute otitis media , normal group , pathology , surgery , otitis , ophthalmology
Objective/Hypothesis In this study, optical coherence tomography (OCT) is used to noninvasively and quantitatively determine tympanic membrane (TM) thickness and the presence and thickness of any middle‐ear biofilm located behind the TM. These new metrics offer the potential to differentiate normal, acute, and chronic otitis media (OM) infections in pediatric subjects. Study Design Case series with comparison group. Methods The TM thickness of 34 pediatric subjects was acquired using a custom‐built, handheld OCT system following a traditional otoscopic ear exam. Results Overall thickness (TM and any associated biofilm) was shown to be statistically different for normal, acute, and chronic infection groups (normal‐acute and normal‐chronic: P value < 0.001; acute‐chronic: P value = 0.0016). Almost all observed scans from the chronic group had an accompanying biofilm structure. When the thickness of the TM and biofilm were considered separately in chronic OM, the chronic TM thickness correlated with the normal group ( P value = 0.68) yet was still distinct from the acute OM group ( P value < 0.001), indicating that the TM in chronic OM returns to relatively normal thickness levels. Conclusion Identifying these physical changes in vivo provides new metrics for noninvasively and quantitatively differentiating normal, acute, and chronic OM. This new diagnostic information has the potential to assist physicians to more effectively and efficiently screen, manage, and refer patients based on quantitative data. Level of Evidence 4. Laryngoscope , 125:E276–E282, 2015