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Liu Y, Lu X, Sun S, Yu H, Li H. The therapeutic use of exosomes in children with adenoid hypertrophy accompanied by otitis media with effusion (AHOME): a protocol study. BMC Pediatr 2024; 24:521. [PMID: 39134977 DOI: 10.1186/s12887-024-04999-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/08/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The adenoids act as a reservoir of bacterial pathogens and immune molecules, and they are significantly involved in children with otitis media with effusion (OME). As an essential carrier of intercellular substance transfer and signal transduction, exosomes with different biological functions can be secreted by various types of cells. There remains significant uncertainty regarding the clinical relevance of exosomes to OME, especially in its pathophysiologic development. In this study, we will seek to determine the biological functions of exosomes in children with adenoid hypertrophy accompanied by OME (AHOME). METHODS The diagnostic criteria for OME in children aged 4-10 years include a disease duration of at least 3 months, type B or C acoustic immittance, and varying degrees of conductive hearing loss. Adenoidal hypertrophy is diagnosed when nasal endoscopy shows at least 60% adenoidal occlusion in the nostrils or when nasopharyngeal lateral X-ray shows A/N > 0.6. Children who meet the indications for adenoidectomy surgery undergo adenoidectomy. Peripheral blood, nasopharyngeal swab, and adenoid tissue will be collected from patients, and the exosomes will be isolated from the samples. Following the initial collection, patients will undergo adenoidectomy and peripheral blood and nasopharyngeal swabs will be collected again after 3 months. EXPECTED RESULTS This study aims to identify differences in exosomes from preoperative adenoid tissue and peripheral blood samples between children with AHOME and those with adenoid hypertrophy alone. Additionally, it seeks to determine changes in microbial diversity in adenoid tissue between these groups. CONCLUSIONS The findings are expected to provide new insights into the diagnosis and treatment of OME, to identify novel biomarkers, and to enhance our understanding of the pathophysiology of OME, potentially leading to the development of innovative diagnostic and therapeutic approaches.
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Affiliation(s)
- Yixuan Liu
- Department of ENT Institute and Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine Research, Demin Han's Academician Workstation, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200032, People's Republic of China
| | - Xiaoling Lu
- Department of ENT Institute and Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine Research, Demin Han's Academician Workstation, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200032, People's Republic of China
| | - Shan Sun
- Department of ENT Institute and Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine Research, Demin Han's Academician Workstation, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200032, People's Republic of China.
| | - Huiqian Yu
- Department of ENT Institute and Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine Research, Demin Han's Academician Workstation, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200032, People's Republic of China.
| | - Huawei Li
- Department of ENT Institute and Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine Research, Demin Han's Academician Workstation, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200032, People's Republic of China.
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, People's Republic of China.
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China.
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Clark GG, Geisler D, Coey EJ, Pollitz LJ, Zaki FR, Huang C, Boppart SA, Nguyen TH. Influence of phosphate on bacterial release from activated carbon point-of-use filters and on biofilm characteristics. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 914:169932. [PMID: 38199359 PMCID: PMC11090127 DOI: 10.1016/j.scitotenv.2024.169932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/29/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
Point-of-use (POU) filters certified to remove lead are often composed of activated carbon and have been shown to release high concentrations of bacteria, including opportunistic pathogens. In this study, we examine the impacts of the common corrosion inhibitor phosphate on biofilm characteristics and the relationship between biofilm structure and bacterial release from POU filters. This knowledge is essential for understanding how best to use the filters and where these filters fit in a system where other lead contamination prevention measures may be in place. We measured the bacterial release from activated carbon POU filters fed with groundwater - a common source of drinking water - with and without phosphate. We used optical coherence tomography (OCT) to quantitatively characterize biofilm growing on activated carbon filter material in which the biofilms were fed groundwater with and without phosphate. Phosphate filters released significantly less (57-87 %) bacteria than groundwater filters, and phosphate biofilms (median thickness: 82-331 μm) grew to be significantly thicker than groundwater biofilms (median thickness: 122-221 μm). The phosphate biofilm roughness ranged from 97 to 142 % of the groundwater biofilm roughness and was significantly greater in most weeks. Phosphate biofilms also had fewer pores per biofilm volume and shorter channels connecting those pores.
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Affiliation(s)
- Gemma G Clark
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, United States of America.
| | - Dietrich Geisler
- Department of Computer Science, Cornell University, United States of America
| | - Evan J Coey
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, United States of America
| | - Lance J Pollitz
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, United States of America
| | - Farzana R Zaki
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, United States of America
| | - Conghui Huang
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, United States of America
| | - Stephen A Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, United States of America; Department of Bioengineering, Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, United States of America; Carle Illinois College of Medicine, United States of America
| | - Thanh H Nguyen
- Department of Civil and Environmental Engineering, University of Illinois at Urbana-Champaign, United States of America; Carle Illinois College of Medicine, United States of America; Institute of Genomic Biology, University of Illinois at Urbana-Champaign, United States of America
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3
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Lui CG, Kim W, Dewey JB, Macías-Escrivá FD, Ratnayake K, Oghalai JS, Applegate BE. In vivo functional imaging of the human middle ear with a hand-held optical coherence tomography device. BIOMEDICAL OPTICS EXPRESS 2021; 12:5196-5213. [PMID: 34513251 PMCID: PMC8407818 DOI: 10.1364/boe.430935] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
We describe an optical coherence tomography and vibrometry system designed for portable hand-held usage in the otology clinic on awake patients. The system provides clinically relevant point-of-care morphological imaging with 14-44 µm resolution and functional vibratory measures with sub-nanometer sensitivity. We evaluated various new approaches for extracting functional information including a multi-tone stimulus, a continuous chirp stimulus, and alternating air and bone stimulus. We also explored the vibratory response over an area of the tympanic membrane (TM) and generated TM thickness maps. Our results suggest that the system can provide real-time in vivo imaging and vibrometry of the ear and could prove useful for investigating otologic pathology in the clinic setting.
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Affiliation(s)
- Christopher G. Lui
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- These authors contributed equally to this work
| | - Wihan Kim
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- These authors contributed equally to this work
| | - James B. Dewey
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Frank D. Macías-Escrivá
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Kumara Ratnayake
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - John S. Oghalai
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Brian E. Applegate
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Denney Research Center (DRB) 140, Los Angeles, CA 90089, USA
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Assessing the Effect of Middle Ear Effusions on Wideband Acoustic Immittance Using Optical Coherence Tomography. Ear Hear 2021; 41:811-824. [PMID: 31634213 PMCID: PMC7165028 DOI: 10.1097/aud.0000000000000796] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Wideband acoustic immittance (WAI) noninvasively assesses middle ear function by measuring the sound conduction over a range of audible frequencies. Although several studies have shown the potential of WAI for detecting the presence of middle ear effusions (MEEs), determining the effects of MEE type and amount on WAI in vivo has been challenging due to the anatomical location of middle ear cavity. The purpose of this study is to correlate WAI measurements with physical characteristics of the middle ear and MEEs determined by optical coherence tomography (OCT), a noninvasive optical imaging technique.
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Kashani RG, Młyńczak MC, Zarabanda D, Solis-Pazmino P, Huland DM, Ahmad IN, Singh SP, Valdez TA. Shortwave infrared otoscopy for diagnosis of middle ear effusions: a machine-learning-based approach. Sci Rep 2021; 11:12509. [PMID: 34131163 PMCID: PMC8206083 DOI: 10.1038/s41598-021-91736-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/04/2021] [Indexed: 02/05/2023] Open
Abstract
Otitis media, a common disease marked by the presence of fluid within the middle ear space, imparts a significant global health and economic burden. Identifying an effusion through the tympanic membrane is critical to diagnostic success but remains challenging due to the inherent limitations of visible light otoscopy and user interpretation. Here we describe a powerful diagnostic approach to otitis media utilizing advancements in otoscopy and machine learning. We developed an otoscope that visualizes middle ear structures and fluid in the shortwave infrared region, holding several advantages over traditional approaches. Images were captured in vivo and then processed by a novel machine learning based algorithm. The model predicts the presence of effusions with greater accuracy than current techniques, offering specificity and sensitivity over 90%. This platform has the potential to reduce costs and resources associated with otitis media, especially as improvements are made in shortwave imaging and machine learning.
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Affiliation(s)
- Rustin G. Kashani
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA
| | - Marcel C. Młyńczak
- grid.1035.70000000099214842Institute of Metrology and Biomedical Engineering, Faculty of Mechatronics, Warsaw University of Technology, Warsaw, Poland
| | - David Zarabanda
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA
| | - Paola Solis-Pazmino
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA
| | - David M. Huland
- grid.168010.e0000000419368956Department of Radiology, Stanford University School of Medicine, Palo Alto, CA USA
| | - Iram N. Ahmad
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA ,grid.414123.10000 0004 0450 875XLucile Packard Children’s Hospital, Palo Alto, CA USA
| | - Surya P. Singh
- grid.495560.b0000 0004 6003 8393Department of Biosciences and Bioengineering, Indian Institute of Technology Dharwad, Dharwad, Karnataka India
| | - Tulio A. Valdez
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA ,grid.414123.10000 0004 0450 875XLucile Packard Children’s Hospital, Palo Alto, CA USA
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Locke A, Fitzgerald S, Mahadevan-Jansen A. Advances in Optical Detection of Human-Associated Pathogenic Bacteria. Molecules 2020; 25:E5256. [PMID: 33187331 PMCID: PMC7696695 DOI: 10.3390/molecules25225256] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023] Open
Abstract
Bacterial infection is a global burden that results in numerous hospital visits and deaths annually. The rise of multi-drug resistant bacteria has dramatically increased this burden. Therefore, there is a clinical need to detect and identify bacteria rapidly and accurately in their native state or a culture-free environment. Current diagnostic techniques lack speed and effectiveness in detecting bacteria that are culture-negative, as well as options for in vivo detection. The optical detection of bacteria offers the potential to overcome these obstacles by providing various platforms that can detect bacteria rapidly, with minimum sample preparation, and, in some cases, culture-free directly from patient fluids or even in vivo. These modalities include infrared, Raman, and fluorescence spectroscopy, along with optical coherence tomography, interference, polarization, and laser speckle. However, these techniques are not without their own set of limitations. This review summarizes the strengths and weaknesses of utilizing each of these optical tools for rapid bacteria detection and identification.
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Affiliation(s)
- Andrea Locke
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA; (A.L.); (S.F.)
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Sean Fitzgerald
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA; (A.L.); (S.F.)
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
| | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center, Nashville, TN 37232, USA; (A.L.); (S.F.)
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232, USA
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7
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Prasad A, Hasan SMA, Gartia MR. Optical Identification of Middle Ear Infection. Molecules 2020; 25:molecules25092239. [PMID: 32397569 PMCID: PMC7248855 DOI: 10.3390/molecules25092239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/16/2022] Open
Abstract
Ear infection is one of the most commonly occurring inflammation diseases in the world, especially for children. Almost every child encounters at least one episode of ear infection before he/she reaches the age of seven. The typical treatment currently followed by physicians is visual inspection and antibiotic prescription. In most cases, a lack of improper treatment results in severe bacterial infection. Therefore, it is necessary to design and explore advanced practices for effective diagnosis. In this review paper, we present the various types of ear infection and the related pathogens responsible for middle ear infection. We outline the conventional techniques along with clinical trials using those techniques to detect ear infections. Further, we highlight the need for emerging techniques to reduce ear infection complications. Finally, we emphasize the utility of Raman spectroscopy as a prospective non-invasive technique for the identification of middle ear infection.
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Preciado D, Nolan RM, Joshi R, Krakovsky GM, Zhang A, Pudik NA, Kumar NK, Shelton RL, Boppart SA, Bauman NM. Otitis Media Middle Ear Effusion Identification and Characterization Using an Optical Coherence Tomography Otoscope. Otolaryngol Head Neck Surg 2020; 162:367-374. [PMID: 31959053 DOI: 10.1177/0194599819900762] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the feasibility of detecting and differentiating middle ear effusions (MEEs) using an optical coherence tomography (OCT) otoscope. STUDY DESIGN Cross-sectional study. SETTING US tertiary care children's hospital. SUBJECTS AND METHODS Seventy pediatric patients undergoing tympanostomy tube placement were preoperatively imaged using an OCT otoscope. A blinded reader quiz was conducted using 24 readers from 4 groups of tiered medical expertise. The primary outcome assessed was reader ability to detect presence/absence of MEE. A secondary outcome assessed was reader ability to differentiate serous vs nonserous MEE. RESULTS OCT image data sets were analyzed from 45 of 70 total subjects. Blinded reader analysis of an OCT data subset for detection of MEE resulted in 90.6% accuracy, 90.9% sensitivity, 90.2% specificity, and intra/interreader agreement of 92.9% and 87.1%, respectively. Differentiating MEE type, reader identification of nonserous MEE had 70.8% accuracy, 53.6% sensitivity, 80.1% specificity, and intra/interreader agreement of 82.9% and 75.1%, respectively. Multivariate analysis revealed that age was the strongest predictor of OCT quality. The mean age of subjects with quality OCT was 5.01 years (n = 45), compared to 2.54 years (n = 25) in the remaining subjects imaged (P = .0028). The ability to capture quality images improved over time, from 50% to 69.4% over the study period. CONCLUSION OCT otoscopy shows promise for facilitating accurate MEE detection. The imageability with the prototype device was affected by age, with older children being easier to image, similar to current ear diagnostic technologies.
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Affiliation(s)
- Diego Preciado
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA.,Sheikh Zayed Institute, CNHS, Washington, DC, USA
| | | | - Radhika Joshi
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA.,Sheikh Zayed Institute, CNHS, Washington, DC, USA
| | - Gina M Krakovsky
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA
| | | | | | | | | | | | - Nancy M Bauman
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA
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Monroy GL, Won J, Dsouza R, Pande P, Hill MC, Porter RG, Novak MA, Spillman DR, Boppart SA. Automated classification platform for the identification of otitis media using optical coherence tomography. NPJ Digit Med 2019; 2:22. [PMID: 31304369 PMCID: PMC6550205 DOI: 10.1038/s41746-019-0094-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/27/2019] [Indexed: 02/06/2023] Open
Abstract
The diagnosis and treatment of otitis media (OM), a common childhood infection, is a significant burden on the healthcare system. Diagnosis relies on observer experience via otoscopy, although for non-specialists or inexperienced users, accurate diagnosis can be difficult. In past studies, optical coherence tomography (OCT) has been used to quantitatively characterize disease states of OM, although with the involvement of experts to interpret and correlate image-based indicators of infection with clinical information. In this paper, a flexible and comprehensive framework is presented that automatically extracts features from OCT images, classifies data, and presents clinically relevant results in a user-friendly platform suitable for point-of-care and primary care settings. This framework was used to test the discrimination between OCT images of normal controls, ears with biofilms, and ears with biofilms and middle ear fluid (effusion). Predicted future performance of this classification platform returned promising results (90%+ accuracy) in various initial tests. With integration into patient healthcare workflow, users of all levels of medical experience may be able to collect OCT data and accurately identify the presence of middle ear fluid and/or biofilms.
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Affiliation(s)
- Guillermo L Monroy
- 1Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL USA.,2Beckman Institute for Advanced Science and Technology, Urbana, IL USA
| | - Jungeun Won
- 1Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL USA.,2Beckman Institute for Advanced Science and Technology, Urbana, IL USA
| | - Roshan Dsouza
- 2Beckman Institute for Advanced Science and Technology, Urbana, IL USA
| | - Paritosh Pande
- 2Beckman Institute for Advanced Science and Technology, Urbana, IL USA
| | - Malcolm C Hill
- 3Carle Foundation Hospital, Otolaryngology, Urbana, IL USA.,4Carle Illinois College of Medicine, Urbana, IL USA
| | - Ryan G Porter
- 3Carle Foundation Hospital, Otolaryngology, Urbana, IL USA.,4Carle Illinois College of Medicine, Urbana, IL USA
| | - Michael A Novak
- 3Carle Foundation Hospital, Otolaryngology, Urbana, IL USA.,4Carle Illinois College of Medicine, Urbana, IL USA
| | - Darold R Spillman
- 2Beckman Institute for Advanced Science and Technology, Urbana, IL USA
| | - Stephen A Boppart
- 1Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL USA.,2Beckman Institute for Advanced Science and Technology, Urbana, IL USA.,3Carle Foundation Hospital, Otolaryngology, Urbana, IL USA.,4Carle Illinois College of Medicine, Urbana, IL USA.,5Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL USA
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Kirsten L, Schindler M, Morgenstern J, Erkkilä MT, Golde J, Walther J, Rottmann P, Kemper M, Bornitz M, Neudert M, Zahnert T, Koch E. Endoscopic optical coherence tomography with wide field-of-view for the morphological and functional assessment of the human tympanic membrane. JOURNAL OF BIOMEDICAL OPTICS 2018; 24:1-11. [PMID: 30516037 PMCID: PMC6975278 DOI: 10.1117/1.jbo.24.3.031017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 11/05/2018] [Indexed: 05/25/2023]
Abstract
An endoscopic optical coherence tomography (OCT) system with a wide field-of-view of 8 mm is presented, which combines the image capability of endoscopic imaging at the middle ear with the advantages of functional OCT imaging, allowing a morphological and functional assessment of the human tympanic membrane. The endoscopic tube has a diameter of 3.5 mm and contains gradient-index optics for simultaneous forward-viewing OCT and video endoscopy. The endoscope allows the three-dimensional visualization of nearly the entire tympanic membrane. In addition, the oscillation of the tympanic membrane is measured spatially resolved and in the frequency range between 500 Hz and 5 kHz with 125 Hz resolution, which is realized by phase-resolved Doppler OCT imaging during acoustical excitation with chirp signals. The applicability of the OCT system is demonstrated in vivo. Due to the fast image acquisition, structural and functional measurements are only slightly affected by motion artifacts.
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Affiliation(s)
- Lars Kirsten
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Anesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Dresden, Germany
| | - Martin Schindler
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Anesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Dresden, Germany
| | - Joseph Morgenstern
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Otorhinolaryngology, Dresden, Germany
| | - Mikael Timo Erkkilä
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Anesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Dresden, Germany
| | - Jonas Golde
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Anesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Dresden, Germany
| | - Julia Walther
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Anesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Dresden, Germany
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Medical Physics and Biomedical Engineering, Dresden, Germany
| | - Pascal Rottmann
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Anesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Dresden, Germany
| | - Max Kemper
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Otorhinolaryngology, Dresden, Germany
| | - Matthias Bornitz
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Otorhinolaryngology, Dresden, Germany
| | - Marcus Neudert
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Otorhinolaryngology, Dresden, Germany
| | - Thomas Zahnert
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Otorhinolaryngology, Dresden, Germany
| | - Edmund Koch
- Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Anesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Dresden, Germany
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Marom T, Kraus O, Habashi N, Tamir SO. Emerging Technologies for the Diagnosis of Otitis Media. Otolaryngol Head Neck Surg 2018; 160:447-456. [PMID: 30396324 DOI: 10.1177/0194599818809337] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To review new experimental techniques for the diagnosis of otitis media (OM). DATA SOURCES Literature search in English in the following databases: MEDLINE (via PubMed), Ovid Medline, Google Scholar, and Clinical Evidence (BMJ Publishing) between January 1, 2005, and April 30, 2018. Subsequently, articles were reviewed and included only if relevant. REVIEW METHODS MeSH terms: ["diagnosis"] AND [all forms of OM] AND ["human"] AND ["ear"] and ["tympanic membrane"]. The retrieved innovative diagnostic techniques rely on and take advantage of the physical properties of the tympanomastoid cavity components: tympanic membrane (TM) thickness, its translucency and compliance; middle ear fluid characteristics; biofilm presence; increased tissue metabolic activity in OM states; and fluid presence in the mastoid cavity. These parameters are taken into account to establish OM diagnosis objectively. We review spectral gradient acoustic reflectometry, digital otoscopy, TM image analysis, multicolor reflectance imaging, anticonfocal middle ear assessment, optical coherence tomography, quantitative pneumatic otoscopy, transmastoid ultrasound, wideband measurements, TM thickness mapping, shortwave infrared imaging, and wideband acoustic transfer functions. CONCLUSIONS New experimental techniques are gradually introduced to overcome the limitations of standard otoscopy. The aforementioned techniques are still under investigation and are pending widespread clinical use. The implementation of these techniques in the market is dependent on their success in clinical trials, as well as on their future cost. IMPLICATION FOR PRACTICE New techniques for the diagnosis of OM can objectively evaluate the morphology of the TM, determine the presence of middle ear fluid and evaluate its content, and thus potentially replace standard otoscopy.
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Affiliation(s)
- Tal Marom
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Oded Kraus
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Nadeem Habashi
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Sharon Ovnat Tamir
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
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Nash R, Shaida A, Saeed S, Khalil S, Lavy J. Recurrent cochlear implant associated seroma: A series of five patients. Cochlear Implants Int 2018; 20:91-93. [PMID: 30381017 DOI: 10.1080/14670100.2018.1541832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: We have observed a small number of patients with cochlear implants who have a tendency to develop recurrent seromas overlying the implant package. Methods: Five patients with a current or previous history of recurrent seromas presenting for review over a three-month period were identified. A retrospective review of their case notes was undertaken. Results: All patients identified were children, with a mean age at first seroma of 5.0 years (range 1.9-10.4 years). The mean interval between implantation and first episode of seroma was 3.1 years (range 0.9-6.4 years). With the exception of imaging showing a fluid-density collection, investigations were generally unremarkable. Fluid aspirated from one patient was cultured and no organisms were grown. Antibiotics, most commonly amoxicillin / clavulanic acid, were commonly but not universally prescribed. Conclusions: Recurrent cochlear implant associated seroma appears to be an idiopathic process. Investigations are generally unhelpful, and whilst it is probably prudent to treat with antibiotics during an initial presentation, once a pattern of recurrent seroma is established, patients can be treated conservatively.
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Affiliation(s)
- Robert Nash
- a Cochlear Implant Department , Royal National Throat, Nose and Ear Hospital , Gray's Inn Road, London WC1X 8DA , UK
| | - Azhar Shaida
- a Cochlear Implant Department , Royal National Throat, Nose and Ear Hospital , Gray's Inn Road, London WC1X 8DA , UK
| | - Shakeel Saeed
- a Cochlear Implant Department , Royal National Throat, Nose and Ear Hospital , Gray's Inn Road, London WC1X 8DA , UK
| | - Sherif Khalil
- a Cochlear Implant Department , Royal National Throat, Nose and Ear Hospital , Gray's Inn Road, London WC1X 8DA , UK
| | - Jeremy Lavy
- a Cochlear Implant Department , Royal National Throat, Nose and Ear Hospital , Gray's Inn Road, London WC1X 8DA , UK
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Magana M, Sereti C, Ioannidis A, Mitchell CA, Ball AR, Magiorkinis E, Chatzipanagiotou S, Hamblin MR, Hadjifrangiskou M, Tegos GP. Options and Limitations in Clinical Investigation of Bacterial Biofilms. Clin Microbiol Rev 2018; 31:e00084-16. [PMID: 29618576 PMCID: PMC6056845 DOI: 10.1128/cmr.00084-16] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Bacteria can form single- and multispecies biofilms exhibiting diverse features based upon the microbial composition of their community and microenvironment. The study of bacterial biofilm development has received great interest in the past 20 years and is motivated by the elegant complexity characteristic of these multicellular communities and their role in infectious diseases. Biofilms can thrive on virtually any surface and can be beneficial or detrimental based upon the community's interplay and the surface. Advances in the understanding of structural and functional variations and the roles that biofilms play in disease and host-pathogen interactions have been addressed through comprehensive literature searches. In this review article, a synopsis of the methodological landscape of biofilm analysis is provided, including an evaluation of the current trends in methodological research. We deem this worthwhile because a keyword-oriented bibliographical search reveals that less than 5% of the biofilm literature is devoted to methodology. In this report, we (i) summarize current methodologies for biofilm characterization, monitoring, and quantification; (ii) discuss advances in the discovery of effective imaging and sensing tools and modalities; (iii) provide an overview of tailored animal models that assess features of biofilm infections; and (iv) make recommendations defining the most appropriate methodological tools for clinical settings.
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Affiliation(s)
- Maria Magana
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
| | - Christina Sereti
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
- Department of Microbiology, Thriassio General Hospital, Attiki, Greece
| | - Anastasios Ioannidis
- Department of Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens, Greece
- Department of Nursing, Faculty of Human Movement and Quality of Life Sciences, University of Peloponnese, Sparta, Greece
| | - Courtney A Mitchell
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Anthony R Ball
- Gliese 623b, Mendon, Massachusetts, USA
- GAMA Therapeutics LLC, Pepperell, Massachusetts, USA
| | - Emmanouil Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens-Goudi, Greece
| | | | - Michael R Hamblin
- Harvard-MIT Division of Health Science and Technology, Cambridge, Massachusetts, USA
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Maria Hadjifrangiskou
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - George P Tegos
- Gliese 623b, Mendon, Massachusetts, USA
- GAMA Therapeutics LLC, Pepperell, Massachusetts, USA
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14
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Tan HEI, Santa Maria PL, Wijesinghe P, Francis Kennedy B, Allardyce BJ, Eikelboom RH, Atlas MD, Dilley RJ. Optical Coherence Tomography of the Tympanic Membrane and Middle Ear: A Review. Otolaryngol Head Neck Surg 2018; 159:424-438. [PMID: 29787354 DOI: 10.1177/0194599818775711] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective To evaluate the recent developments in optical coherence tomography (OCT) for tympanic membrane (TM) and middle ear (ME) imaging and to identify what further development is required for the technology to be integrated into common clinical use. Data Sources PubMed, Embase, Google Scholar, Scopus, and Web of Science. Review Methods A comprehensive literature search was performed for English language articles published from January 1966 to January 2018 with the keywords "tympanic membrane or middle ear,""optical coherence tomography," and "imaging." Conclusion Conventional imaging techniques cannot adequately resolve the microscale features of TM and ME, sometimes necessitating diagnostic exploratory surgery in challenging otologic pathology. As a high-resolution noninvasive imaging technique, OCT offers promise as a diagnostic aid for otologic conditions, such as otitis media, cholesteatoma, and conductive hearing loss. Using OCT vibrometry to image the nanoscale vibrations of the TM and ME as they conduct acoustic waves may detect the location of ossicular chain dysfunction and differentiate between stapes fixation and incus-stapes discontinuity. The capacity of OCT to image depth and thickness at high resolution allows 3-dimensional volumetric reconstruction of the ME and has potential use for reconstructive tympanoplasty planning and the follow-up of ossicular prostheses. Implications for Practice To achieve common clinical use beyond these initial discoveries, future in vivo imaging devices must feature low-cost probe or endoscopic designs and faster imaging speeds and demonstrate superior diagnostic utility to computed tomography and magnetic resonance imaging. While such technology has been available for OCT, its translation requires focused development through a close collaboration between engineers and clinicians.
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Affiliation(s)
- Hsern Ern Ivan Tan
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia.,3 Department of Otolaryngology-Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Australia
| | - Peter Luke Santa Maria
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia.,4 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Philip Wijesinghe
- 5 BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre; Centre for Medical Research, The University of Western Australia, Nedlands, Australia.,6 Department of Electrical, Electronic, and Computer Engineering, School of Engineering, The University of Western Australia, Nedlands, Australia
| | - Brendan Francis Kennedy
- 5 BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre; Centre for Medical Research, The University of Western Australia, Nedlands, Australia.,6 Department of Electrical, Electronic, and Computer Engineering, School of Engineering, The University of Western Australia, Nedlands, Australia
| | | | - Robert Henry Eikelboom
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia.,8 Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Marcus David Atlas
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia
| | - Rodney James Dilley
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia
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15
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Monroy GL, Hong W, Khampang P, Porter RG, Novak MA, Spillman DR, Barkalifa R, Chaney EJ, Kerschner JE, Boppart SA. Direct Analysis of Pathogenic Structures Affixed to the Tympanic Membrane during Chronic Otitis Media. Otolaryngol Head Neck Surg 2018; 159:117-126. [PMID: 29587128 DOI: 10.1177/0194599818766320] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective To characterize otitis media-associated structures affixed to the mucosal surface of the tympanic membrane (TM) in vivo and in surgically recovered in vitro samples. Study Design Prospective case series without comparison. Setting Outpatient surgical care center. Subjects and Methods Forty pediatric subjects scheduled for tympanostomy tube placement surgery were imaged intraoperatively under general anesthesia. Postmyringotomy, a portable optical coherence tomography (OCT) imaging system assessed for the presence of any biofilm affixed to the mucosal surface of the TM. Samples of suspected microbial infection-related structures were collected through the myringotomy incision. The sampled site was subsequently reimaged with OCT to confirm collection from the original image site on the TM. In vitro analysis based on confocal laser scanning microscope (CLSM) images of fluorescence in situ hybridization-tagged samples and polymerase chain reaction (PCR) provided microbiological characterization and verification of biofilm activity. Results OCT imaging was achieved for 38 of 40 subjects (95%). Images from 38 of 38 (100%) of subjects observed with OCT showed the presence of additional microbial infection-related structures. Thirty-four samples were collected from these 38 subjects. CLSM images provided evidence of clustered bacteria in 32 of 33 (97%) of samples. PCR detected the presence of active bacterial DNA signatures in 20 of 31 (65%) of samples. Conclusion PCR and CLSM analysis of fluorescence in situ hybridization-stained samples validates the presence of active bacteria that have formed into a middle ear biofilm that extends across the mucosal layer of the TM. OCT can rapidly and noninvasively identify middle ear biofilms in subjects with severe and persistent cases of otitis media.
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Affiliation(s)
- Guillermo L Monroy
- 1 Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,2 Beckman Institute for Advanced Science and Technology, Urbana, Illinois, USA
| | - Wenzhou Hong
- 3 Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Ryan G Porter
- 4 Department of Otolaryngology-Head and Neck Surgery, Carle Foundation Hospital, Urbana, Illinois, USA.,5 Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Michael A Novak
- 4 Department of Otolaryngology-Head and Neck Surgery, Carle Foundation Hospital, Urbana, Illinois, USA.,5 Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Darold R Spillman
- 2 Beckman Institute for Advanced Science and Technology, Urbana, Illinois, USA
| | - Ronit Barkalifa
- 2 Beckman Institute for Advanced Science and Technology, Urbana, Illinois, USA
| | - Eric J Chaney
- 2 Beckman Institute for Advanced Science and Technology, Urbana, Illinois, USA
| | | | - Stephen A Boppart
- 1 Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.,2 Beckman Institute for Advanced Science and Technology, Urbana, Illinois, USA.,5 Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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16
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Huang PC, Chaney EJ, Shelton RL, Boppart SA. Magnetomotive Displacement of the Tympanic Membrane Using Magnetic Nanoparticles: Toward Enhancement of Sound Perception. IEEE Trans Biomed Eng 2018; 65:2837-2846. [PMID: 29993404 DOI: 10.1109/tbme.2018.2819649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A novel hearing-aid scheme using magnetomotive nanoparticles (MNPs) as transducers in the tympanic membrane (TM) is proposed, aiming to noninvasively and directly induce a modulated vibration on the TM. METHODS In this feasibility study, iron oxide (Fe3O4) nanoparticles were applied on ex vivo rat TM tissues and allowed to diffuse over ∼2 h. Subsequently, magnetic force was exerted on the MNP-laden TM via a programmable electromagnetic solenoid to induce the magnetomotion. Optical coherence tomography (OCT), along with its phase-sensitive measurement capabilities, was utilized to visualize and quantify the nanometer-scale vibrations generated on the TM tissues. RESULTS The magnetomotive displacements induced on the TM were significantly greater than the baseline vibration of the TM without MNPs. In addition to a pure frequency tone, a chirped excitation and the corresponding spectroscopic response were also successfully generated and obtained. Finally, visualization of volumetric TM dynamics was achieved. CONCLUSION This study demonstrates the effectiveness of magnetically inducing vibrations on TMs containing iron oxide nanoparticles, manipulating the amplitude and the frequency of the induced TM motions, and the capability of assessing the magnetomotive dynamics via OCT. SIGNIFICANCE The results demonstrated here suggest the potential use of this noninvasive magnetomotive approach in future hearing aid applications. OCT can be utilized to investigate the magnetomotive dynamics of the TM, which may either enhance sound perception or magnetically induce the perception of sound without the need for acoustic speech signals.
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17
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Won J, Monroy GL, Huang PC, Dsouza R, Hill MC, Novak MA, Porter RG, Chaney E, Barkalifa R, Boppart SA. Pneumatic low-coherence interferometry otoscope to quantify tympanic membrane mobility and middle ear pressure. BIOMEDICAL OPTICS EXPRESS 2018; 9:397-409. [PMID: 29552381 PMCID: PMC5854046 DOI: 10.1364/boe.9.000397] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/18/2017] [Accepted: 12/21/2017] [Indexed: 05/20/2023]
Abstract
Pneumatic otoscopy to assess the mobility of the tympanic membrane (TM) is a highly recommended diagnostic method of otitis media (OM), a widespread middle ear infection characterized by the fluid accumulation in the middle ear. Nonetheless, limited depth perception and subjective interpretation of small TM displacements have challenged the appropriate and efficient examination of TM dynamics experienced during OM. In this paper, a pneumatic otoscope integrated with low coherence interferometry (LCI) was adapted with a controlled pressure-generating system to record the pneumatic response of the TM and to estimate middle ear pressure (MEP). Forty-two ears diagnosed as normal (n = 25), with OM (n = 10), or associated with an upper respiratory infection (URI) (n = 7) were imaged with a pneumatic LCI otoscope with an axial, transverse, and temporal resolution of 6 µm, 20 µm, and 1 msec, respectively. The TM displacement under pneumatic pressure transients (a duration of 0.5 sec with an intensity of ± 150 daPa) was measured to compute two metrics (compliance and amplitude ratio). These metrics were correlated with peak acoustic admittance and MEP from tympanometry and statistically compared via Welch's t-test. As a result, the compliance represents pneumatic TM mobility, and the amplitude ratio estimates MEP. The presence of a middle ear effusion (MEE) significantly decreased compliance (p<0.001). The amplitude ratio of the OM group was statistically less than that of the normal group (p<0.01), indicating positive MEP. Unlike tympanometry, pneumatic LCI otoscopy quantifies TM mobility as well as MEP regardless of MEE presence. With combined benefits of pneumatic otoscopy and tympanometry, pneumatic LCI otoscopy may provide new quantitative metrics for understanding TM dynamics and diagnosing OM.
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Affiliation(s)
- Jungeun Won
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 1304 W. Springfield Avenue, Urbana, IL 61801, USA
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Guillermo L. Monroy
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 1304 W. Springfield Avenue, Urbana, IL 61801, USA
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Pin-Chieh Huang
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 1304 W. Springfield Avenue, Urbana, IL 61801, USA
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Roshan Dsouza
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Malcolm C. Hill
- Carle-Illinois College of Medicine, University of Illinois Urbana-Champaign, 807 South Wright Street, Champaign, IL 61820, USA
- Department of Pediatrics, Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801, USA
| | - Michael A. Novak
- Carle-Illinois College of Medicine, University of Illinois Urbana-Champaign, 807 South Wright Street, Champaign, IL 61820, USA
- Department of Otolaryngology, Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801, USA
| | - Ryan G. Porter
- Carle-Illinois College of Medicine, University of Illinois Urbana-Champaign, 807 South Wright Street, Champaign, IL 61820, USA
- Department of Otolaryngology, Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801, USA
| | - Eric Chaney
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Ronit Barkalifa
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
| | - Stephen A. Boppart
- Department of Bioengineering, University of Illinois at Urbana-Champaign, 1304 W. Springfield Avenue, Urbana, IL 61801, USA
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL 61801, USA
- Carle-Illinois College of Medicine, University of Illinois Urbana-Champaign, 807 South Wright Street, Champaign, IL 61820, USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, 306 N Wright Street, Urbana, IL 61801, USA
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18
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Effects of Negative Middle Ear Pressure on Wideband Acoustic Immittance in Normal-Hearing Adults. Ear Hear 2018; 37:452-64. [PMID: 26871877 DOI: 10.1097/aud.0000000000000280] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Wideband acoustic immittance (WAI) measurements are capable of quantifying middle ear performance over a wide range of frequencies relevant to human hearing. Static pressure in the middle ear cavity affects sound transmission to the cochlea, but few datasets exist to quantify the relationship between middle ear transmission and the static pressure. In this study, WAI measurements of normal ears are analyzed in both negative middle ear pressure (NMEP) and ambient middle ear pressure (AMEP) conditions, with a focus on the effects of NMEP in individual ears. DESIGN Eight subjects with normal middle ear function were trained to induce consistent NMEPs, quantified by the tympanic peak pressure (TPP) and WAI. The effects of NMEP on the wideband power absorbance level are analyzed for individual ears. Complex (magnitude and phase) WAI quantities at the tympanic membrane (TM) are studied by removing the delay due to the residual ear canal (REC) volume between the probe tip and the TM. WAI results are then analyzed using a simplified classical model of the middle ear. RESULTS For the 8 ears presented here, NMEP has the largest and most significant effect across ears from 0.8 to 1.9 kHz, resulting in reduced power absorbance by the middle ear and cochlea. On average, NMEP causes a decrease in the power absorbance level for low- to mid-frequencies, and a small increase above about 4 kHz. The effects of NMEP on WAI quantities, including the absorbance level and TM impedance, vary considerably across ears. The complex WAI at the TM and fitted model parameters show that NMEP causes a decrease in the aggregate compliance at the TM. Estimated REC delays show little to no dependence on NMEP. CONCLUSIONS In agreement with previous results, these data show that the power absorbance level is most sensitive to NMEP around 1 kHz. The REC effect is removed from WAI measurements, allowing for direct estimation of complex WAI at the TM. These estimates show NMEP effects consistent with an increased stiffness in the middle ear, which could originate from the TM, tensor tympani, annular ligament, or other middle ear structures. Model results quantify this nonlinear, stiffness-related change in a systematic way, that is not dependent on averaging WAI results in frequency bands. Given the variability of pressure effects, likely related to intersubject variability at AMEP, TPP is not a strong predictor of change in WAI at the TM. More data and modeling will be needed to better quantify the relationship between NMEP, WAI, and middle ear transmission.
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Monroy GL, Pande P, Nolan RM, Shelton RL, Porter RG, Novak MA, Spillman DR, Chaney EJ, McCormick DT, Boppart SA. Noninvasive in vivo optical coherence tomography tracking of chronic otitis media in pediatric subjects after surgical intervention. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-11. [PMID: 29275547 PMCID: PMC5745859 DOI: 10.1117/1.jbo.22.12.121614] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 12/15/2017] [Indexed: 05/12/2023]
Abstract
In an institutional review board-approved study, 25 pediatric subjects diagnosed with chronic or recurrent otitis media were observed over a period of six months with optical coherence tomography (OCT). Subjects were followed throughout their treatment at the initial patient evaluation and preoperative consultation, surgery (intraoperative imaging), and postoperative follow-up, followed by an additional six months of records-based observation. At each time point, the tympanic membrane (at the light reflex region) and directly adjacent middle-ear cavity were observed in vivo with a handheld OCT probe and portable system. Imaging results were compared with clinical outcomes to correlate the clearance of symptoms in relation to changes in the image-based features of infection. OCT images of most all participants showed the presence of additional infection-related biofilm structures during their initial consultation visit and similarly for subjects imaged intraoperatively before myringotomy. Subjects with successful treatment (no recurrence of infectious symptoms) had no additional structures visible in OCT images during the postoperative visit. OCT image findings suggest surgical intervention consisting of myringotomy and tympanostomy tube placement provides a means to clear the middle ear of infection-related components, including middle-ear fluid and biofilms. Furthermore, OCT was demonstrated as a rapid diagnostic tool to prospectively monitor patients in both outpatient and surgical settings.
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Affiliation(s)
- Guillermo L. Monroy
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Paritosh Pande
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Ryan M. Nolan
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Ryan L. Shelton
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
| | - Ryan G. Porter
- Carle Foundation Hospital, Department of Otolaryngology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
| | - Michael A. Novak
- Carle Foundation Hospital, Department of Otolaryngology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
| | - Darold R. Spillman
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Eric J. Chaney
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | | | - Stephen A. Boppart
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
- Address all correspondence to: Stephen A. Boppart, E-mail:
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Preciado D, Granath A, Lin J, Val S, Kurabi A, Johnston N, Vijayasekaran S, Valdez T, Depireux D, Hermansson A. Panel 8: Report on Recent Advances in Molecular and Cellular Biochemistry. Otolaryngol Head Neck Surg 2017; 156:S106-S113. [PMID: 28372528 DOI: 10.1177/0194599816658290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives To update the medical literature on recent cellular and molecular advances in otitis media disease models with a principal focus on developments in the past 5 years. We also aim to explain recent translational advances in cellular and molecular biology that have influenced our understanding and management of otitis media. Data Sources PubMed-indexed peer-reviewed articles. Review Methods A comprehensive review of the literature was conducted with the term otitis media and the following search terms: molecular biology, cell biology, innate immunity, oxidative stress, mucins, molecular diagnostics. Included articles were published in the English language from January 1, 2010, to July 31, 2015. Implications for Practice The molecular understanding of otitis media disease progression has rapidly advanced over the last 5 years. The roles of inflammation, mucins, and cell signaling mechanisms have been elucidated and defined. Advances in the field provide a plethora of opportunities for innovative molecular targeting in the development of novel therapeutic strategies for otitis media.
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Affiliation(s)
- Diego Preciado
- 1 Shiekh Zayed Institute for Pediatric Surgical Innovation, Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA
| | - Anna Granath
- 2 Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
| | - Jizhen Lin
- 3 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stéphanie Val
- 1 Shiekh Zayed Institute for Pediatric Surgical Innovation, Pediatric Otolaryngology, Children's National Health System, Washington, DC, USA
| | - Arwa Kurabi
- 4 Division of Otolaryngology, Department of Surgery, University of California, San Diego, California, USA
| | - Nikki Johnston
- 5 Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shyan Vijayasekaran
- 6 Department of Surgery, Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Tulio Valdez
- 7 Division of Pediatric Otolaryngology, Connecticut Children's Hospital, Hartford, Connecticut, USA
| | - Didier Depireux
- 8 Institute for Systems Research, University of Maryland, College Park, Maryland, USA
| | - Ann Hermansson
- 9 Departments of Otolaryngology, Oral and Maxillofacial Surgery, and Pediatrics, Lund University, Lund, Sweden
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21
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Percival SL. Importance of biofilm formation in surgical infection. Br J Surg 2017; 104:e85-e94. [PMID: 28121033 DOI: 10.1002/bjs.10433] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 10/26/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Biofilms are ubiquitous, and have been observed in both acute and chronic wounds. Their role in wound healing and infection, however, remains controversial. The aim of this review was to provide an overview of the role and relevance of biofilms to surgical wounds. METHODS A search of PubMed, Science Direct and Web of Science databases was performed to identify studies related to biofilms. Specifically, studies were sought in acute and chronic wounds, and the management and treatment of non-healing and infected skin and wounds. RESULTS Biofilms may develop in all open wounds. In chronic wounds, biofilms may play a role in prolonging and preventing healing, causing chronic inflammation and increasing the risk of infection. Controversies exist regarding the methods presently employed for biofilm detection and management and few data exist to underpin these decisions. CONCLUSION Biofilms in acute surgical and chronic wounds appear to cause a delay in healing and potentially increase the risk of infection. Biofilms can be prevented and once developed can be controlled using wound desloughing and debridement.
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Affiliation(s)
- S L Percival
- 5D Health Protection Group Ltd, Liverpool Bio-Innovation Hub, William Duncan Building, West Derby Street, Liverpool L7 8TX, UK
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Park K, Cho NH, Jang JH, Lee SH, Kim P, Jeon M, Boppart SA, Kim J, Jung W. In vivo 3D imaging of the human tympanic membrane using a wide-field diagonal-scanning optical coherence tomography probe. APPLIED OPTICS 2017; 56:D115-D119. [PMID: 28375378 PMCID: PMC5508522 DOI: 10.1364/ao.56.00d115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
A wide-field optical coherence tomography (OCT) probe was developed that adapts a diagonal-scanning scheme for three-dimensional (3D) in vivo imaging of the human tympanic membrane. The probe consists of a relay lens to enhance the lateral scanning range up to 7 mm. Motion artifacts that occur with the use of handheld probes were found to be decreased owing to the diagonal-scanning pattern, which crosses the center of the sample to facilitate entire 3D scans. 3D images could be constructed from a small number of two-dimensional OCT images acquired using the diagonal-scanning technique. To demonstrate the usefulness and performance of the developed system with the handheld probe, in vivo tympanic membranes of humans and animals were imaged in real time.
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Affiliation(s)
- Kibeom Park
- School of Electronics Engineering, Kyungpook National University, Daegu 702-701, South Korea
- Oz-tec Co., Ltd., Daegu 702-701, South Korea
| | - Nam Hyun Cho
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary (MEEI), 243, Charles Street, Boston, Massachusetts 02114, USA
- Department of Otology and Laryngology, Harvard Medical School, 243, Charles Street, Boston, Massachusetts 02114, USA
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon, South Korea
| | - Sang Heun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Daegu Veterans Hospital, Daegu 704-802, South Korea
| | - Pilun Kim
- Oz-tec Co., Ltd., Daegu 702-701, South Korea
| | - Mansik Jeon
- School of Electronics Engineering, Kyungpook National University, Daegu 702-701, South Korea
| | - Stephen A. Boppart
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, USA
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois 61801, USA
| | - Jeehyun Kim
- School of Electronics Engineering, Kyungpook National University, Daegu 702-701, South Korea
| | - Woonggyu Jung
- Ulsan National Institute of Science and Technology, School of Nano-Bioscience and Chemical Engineering, 689-798, South Korea
- Corresponding author:
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Doppler optical coherence tomography as a promising tool for detecting fluid in the human middle ear. CURRENT DIRECTIONS IN BIOMEDICAL ENGINEERING 2016. [DOI: 10.1515/cdbme-2016-0098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractThe treatment of otitis media requires classifying the effusion in the tympanic cavity for choosing appropriate therapeutic strategies. Otoscopic examination of the middle ear depends on the expertise of the physician and is often hampered in case of inflammatory alterations of the tympanic membrane. In otologic research, optical coherence tomography is an innovative non-invasive imaging technique utilized for visualizing the tympanic membrane. This ex vivo study presents the possibility of OCT and Doppler-OCT for the detection of effusions in the tympanic cavity. Structural OCT imaging allows the direct visualization of scattering fluids behind the tympanic membrane. In addition, the measurement of the reduced oscillation amplitude by means of Doppler-OCT permits the indirect detection of scattering and transparent fluids.
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Abstract
Visualizing structures deep inside opaque biological tissues is one of the central challenges in biomedical imaging. Optical imaging with visible light provides high resolution and sensitivity; however, scattering and absorption of light by tissue limits the imaging depth to superficial features. Imaging with shortwave infrared light (SWIR, 1-2 μm) shares many advantages of visible imaging, but light scattering in tissue is reduced, providing sufficient optical penetration depth to noninvasively interrogate subsurface tissue features. However, the clinical potential of this approach has been largely unexplored because suitable detectors, until recently, have been either unavailable or cost prohibitive. Here, taking advantage of newly available detector technology, we demonstrate the potential of SWIR light to improve diagnostics through the development of a medical otoscope for determining middle ear pathologies. We show that SWIR otoscopy has the potential to provide valuable diagnostic information complementary to that provided by visible pneumotoscopy. We show that in healthy adult human ears, deeper tissue penetration of SWIR light allows better visualization of middle ear structures through the tympanic membrane, including the ossicular chain, promontory, round window niche, and chorda tympani. In addition, we investigate the potential for detection of middle ear fluid, which has significant implications for diagnosing otitis media, the overdiagnosis of which is a primary factor in increased antibiotic resistance. Middle ear fluid shows strong light absorption between 1,400 and 1,550 nm, enabling straightforward fluid detection in a model using the SWIR otoscope. Moreover, our device is easily translatable to the clinic, as the ergonomics, visual output, and operation are similar to a conventional otoscope.
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Pawlowski ME, Shrestha S, Park J, Applegate BE, Oghalai JS, Tkaczyk TS. Miniature, minimally invasive, tunable endoscope for investigation of the middle ear. BIOMEDICAL OPTICS EXPRESS 2015; 6:2246-57. [PMID: 26114043 PMCID: PMC4473758 DOI: 10.1364/boe.6.002246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 05/03/2023]
Abstract
We demonstrate a miniature, tunable, minimally invasive endoscope for diagnosis of the auditory system. The probe is designed to sharply image anatomical details of the middle ear without the need for physically adjusting the position of the distal end of the endoscope. This is achieved through the addition of an electrowetted, tunable, electronically-controlled lens to the optical train. Morphological imaging is enabled by scanning light emanating from an optical coherence tomography system. System performance was demonstrated by imaging part of the ossicular chain and wall of the middle ear cavity of a normal mouse. During the experiment, we electronically moved the plane of best focus from the incudo-stapedial joint to the stapedial artery. Repositioning the object plane allowed us to image anatomical details of the middle ear beyond the depth of field of a static optical system. We also demonstrated for the first time to our best knowledge, that an optical system with an electrowetted, tunable lens may be successfully employed to measure sound-induced vibrations within the auditory system by measuring the vibratory amplitude of the tympanic membrane in a normal mouse in response to pure tone stimuli.
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Affiliation(s)
- Michal E. Pawlowski
- William Marsh Rice University, Department of Bioengineering, 6100 Main St, Houston, TX 77030, USA
| | - Sebina Shrestha
- Texas A&M University, Department of Biomedical Engineering, 5045 Emerging Technology Building, College Station, TX 77843, USA
| | - Jesung Park
- Texas A&M University, Department of Biomedical Engineering, 5045 Emerging Technology Building, College Station, TX 77843, USA
| | - Brian E. Applegate
- Texas A&M University, Department of Biomedical Engineering, 5045 Emerging Technology Building, College Station, TX 77843, USA
| | - John S. Oghalai
- Stanford University, Department of Otolaryngology-Head and Neck Surgery, 801 Welch Road, Stanford, CA 94305, USA
| | - Tomasz S. Tkaczyk
- William Marsh Rice University, Department of Bioengineering, 6100 Main St, Houston, TX 77030, USA
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Zou J, Hannula M, Misra S, Feng H, Labrador RH, Aula AS, Hyttinen J, Pyykkö I. Micro CT visualization of silver nanoparticles in the middle and inner ear of rat and transportation pathway after transtympanic injection. J Nanobiotechnology 2015; 13:5. [PMID: 25622551 PMCID: PMC4312601 DOI: 10.1186/s12951-015-0065-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 01/07/2015] [Indexed: 12/20/2022] Open
Abstract
Background Silver nanoparticles (Ag NPs) displayed strong activities in anti-bacterial, anti-viral, and anti-fungal studies and were reportedly efficient in treating otitis media. Information on distribution of AgNPs in different compartments of the ear is lacking. Objective To detect distribution of Ag NPs in the middle and inner ear and transportation pathways after transtympanic injection. Methods Contrast effect of Ag NPs in the micro CT imaging was assessed in a phantom. AgNPs at various concentrations (1.85 mM, 37.1 mM, and 370.7 mM) were administered to rat middle ear using transtympanic injection and cadaver heads were imaged using micro CT at several time points. Results The lowest concentration of Ag NPs that could be visualized using micro CT was 37.1 mM. No difference was observed between the solvents, deionized H2O and saline. Ag NPs at 37.1 mM were visible in the middle ear on 7 d post-administration. Ag NPs at 370.7 mM generated signals in the middle ear, ossicular chain, round window membrane, oval window, scala tympani, and Eustachian tube for both 4 h and 24 h time points. A gradient distribution of Ag NPs from the middle ear to the inner ear was detected. The pathways for Ag NPs to be transported from the middle ear into the inner ear are round and oval windows. Conclusion This study provided the imaging evidence that Ag NPs are able to access the inner ear in a dose-dependent manner after intratympanic administration, which is relevant to design the delivery concentration in the future clinic application in order to avoid adverse inner ear effect.
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Affiliation(s)
- Jing Zou
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland. .,Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
| | - Markus Hannula
- BioMediTech and Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland.
| | - Superb Misra
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, UK. .,Materials Science and Engineering, Indian Institute of Technology-Gandhinagar, Ahmedabad, India.
| | - Hao Feng
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland.
| | | | - Antti S Aula
- BioMediTech and Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland. .,Department of Medical Physics, Imaging Centre, Tampere University Hospital, Tampere, Finland.
| | - Jari Hyttinen
- BioMediTech and Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland.
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Medisiinarinkatu 3, 33520, Tampere, Finland.
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Heidari AE, Moghaddam S, Truong KK, Chou L, Genberg C, Brenner M, Chen Z. Visualizing biofilm formation in endotracheal tubes using endoscopic three-dimensional optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:126010. [PMID: 26720877 PMCID: PMC4686586 DOI: 10.1117/1.jbo.20.12.126010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/23/2015] [Indexed: 05/23/2023]
Abstract
Biofilm formation has been linked to ventilator-associated pneumonia, which is a prevalent infection in hospital intensive care units. Currently, there is no rapid diagnostic tool to assess the degree of biofilm formation or cellular biofilm composition. Optical coherence tomography (OCT) is a minimally invasive, nonionizing imaging modality that can be used to provide high-resolution cross-sectional images. Biofilm deposited in critical care patients’ endotracheal tubes was analyzed in vitro. This study demonstrates that OCT could potentially be used as a diagnostic tool to analyze and assess the degree of biofilm formation and extent of airway obstruction caused by biofilm in endotracheal tubes.
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Affiliation(s)
- Andrew E. Heidari
- University of California Irvine, Samueli School of Engineering, Department of Biomedical Engineering, 5200 Engineering Hall, Irvine, California 92697-2700, United States
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
| | - Samer Moghaddam
- University of California Irvine, UC Irvine Health, Pulmonology, 101, The City Drive South, Orange, California 92868, United States
| | - Kimberly K. Truong
- University of California Irvine, UC Irvine Health, Pulmonology, 101, The City Drive South, Orange, California 92868, United States
| | - Lidek Chou
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
| | - Carl Genberg
- N8 Medical, 7165 Mira Monte Circle, Las Vegas, Nevada 89120, United States
| | - Matthew Brenner
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
- University of California Irvine, UC Irvine Health, Pulmonology, 101, The City Drive South, Orange, California 92868, United States
| | - Zhongping Chen
- University of California Irvine, Samueli School of Engineering, Department of Biomedical Engineering, 5200 Engineering Hall, Irvine, California 92697-2700, United States
- Beckman Laser Institute, 1002 Health Sciences Road, Irvine, California 92617, United States
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Zou J, Feng H, Mannerström M, Heinonen T, Pyykkö I. Toxicity of silver nanoparticle in rat ear and BALB/c 3T3 cell line. J Nanobiotechnology 2014; 12:52. [PMID: 25467963 PMCID: PMC4272548 DOI: 10.1186/s12951-014-0052-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 11/12/2014] [Indexed: 11/18/2022] Open
Abstract
Background Silver nanoparticles (AgNPs) displayed strong activities in anti-bacterial, anti-viral, and anti-fungal studies and was reportedly efficient in treating otitis media .The potential impact of AgNPs on the inner ear was missing. Objective Attempted to evaluate the potential toxicity of AgNPs in the inner ear, middle ear, and external ear canal after transtympanic injection in rats. Results In in vitro studies, the IC50 for AgNPs in neutral red uptake assay was lower than that in NAD(P)H-dependent cellular oxidoreductase enzyme assay (WST-1) and higher than that in total cellular ATP and nuclear membrane integrity (propidium iodide) assessments. In in vivo experiments, magnetic resonance imaging (MRI) showed that significant changes in the permeability of biological barriers occurred in the middle ear mucosa, the skin of the external ear canal, and the inner ear at 5 h post-transtympanic injection of AgNPs at concentrations ranging from 20 μg/ml to 4000 μg/ml. The alterations in permeability showed a dosage-response relationship, and were reversible. The auditory brainstem response showed that 4000 μg/ml AgNPs induced hearing loss with partial recovery at 7 d, whereas 20 μg/ml caused reversible hearing loss. The functional change in auditory system was in line with the histology results. In general, the BALB/c 3T3 cell line is more than 1000 times more sensitive than the in vivo studies. Impairment of the mitochondrial function was indicated to be the mechanism of toxicity of AgNPs. Conclusion These results suggest that AgNPs caused significant, dose-dependent changes in the permeability of biological barriers in the middle ear mucosa, the skin of the external ear canal, and the inner ear. In general, the BALB/c 3T3 cell line is more than 1000 times more sensitive than the in vivo studies. The rat ear model might be expended to other engineered nanomaterials in nanotoxicology study. Electronic supplementary material The online version of this article (doi:10.1186/s12951-014-0052-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jing Zou
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland. .,Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China.
| | - Hao Feng
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland.
| | - Marika Mannerström
- The Finnish Centre for Alternative Methods, School of Medicine, University of Tampere, Tampere, Finland.
| | - Tuula Heinonen
- The Finnish Centre for Alternative Methods, School of Medicine, University of Tampere, Tampere, Finland.
| | - Ilmari Pyykkö
- Hearing and Balance Research Unit, Field of Oto-laryngology, School of Medicine, University of Tampere, Tampere, Finland.
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Microanatomy of the tympanic membrane in chronic myringitis obtained with optical coherence tomography. Eur Arch Otorhinolaryngol 2014; 272:3217-23. [PMID: 25384576 DOI: 10.1007/s00405-014-3373-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
Abstract
A microscope-based optical coherence tomography (OCT) device was used to assess the microanatomy of the tympanic membrane in patients with chronic myringitis. A prospective study was designed for this purpose. OCT measurements of the tympanic membrane were done on 11 patients with myringitis with a microscope-based spectral domain OCT system. The in vivo findings were compared with those findings of a control group consisting of 36 patients with retraction pockets or atrophic tympanic membranes (n = 13), myringosclerosis (n = 12) and perforations (n = 11). In active chronic myringitis, the thickness of the tympanic membrane is increased compared to healthy membranes and to other pathological conditions of the tympanic membrane. Consistent changes of the microanatomy of the tympanic membrane were found in chronic myringitis with OCT. Serial OCT measurements revealed no biofilm suspicious findings in all patients with active chronic myringitis. Intraoperative and in vivo OCT measurements may help to detect microanatomical changes of the tympanic membrane in chronic myringitis and in other conditions of the tympanic membrane.
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Cho NH, Jang JH, Jung W, Kim J. In vivo imaging of middle-ear and inner-ear microstructures of a mouse guided by SD-OCT combined with a surgical microscope. OPTICS EXPRESS 2014; 22:8985-95. [PMID: 24787787 PMCID: PMC4083046 DOI: 10.1364/oe.22.008985] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We developed an augmented-reality system that combines optical coherence tomography (OCT) with a surgical microscope. By sharing the common optical path in the microscope and OCT, we could simultaneously acquire OCT and microscope views. The system was tested to identify the middle-ear and inner-ear microstructures of a mouse. Considering the probability of clinical application including otorhinolaryngology, diseases such as middle-ear effusion were visualized using in vivo mouse and OCT images simultaneously acquired through the eyepiece of the surgical microscope during surgical manipulation using the proposed system. This system is expected to realize a new practical area of OCT application.
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Affiliation(s)
- Nam Hyun Cho
- School of Electrical Engineering, Kyungpook National University, 1370, Sankyuk 3-dong, Buk-gu, Daegu 702-701, South Korea
| | - Jeong Hun Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University, College of Medicine, 680 Gukchaebosang-ro, Jung-gu, Daegu 700-842, South Korea
| | - Woonggyu Jung
- School of Nano-Bioscience and Chemical Engineering, Ulsan National Institute of Science and Technology 100, Banyeon-ri, Eonyang-eup, Ulju-gun, Ulsan 689-798, South Korea
| | - Jeehyun Kim
- School of Electrical Engineering, Kyungpook National University, 1370, Sankyuk 3-dong, Buk-gu, Daegu 702-701, South Korea
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Coticchia JM, Chen M, Sachdeva L, Mutchnick S. New paradigms in the pathogenesis of otitis media in children. Front Pediatr 2013; 1:52. [PMID: 24400296 PMCID: PMC3874850 DOI: 10.3389/fped.2013.00052] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 12/12/2013] [Indexed: 01/18/2023] Open
Abstract
Acute otitis media (AOM) is a multifactorial disease with a significant socioeconomic impact. The pathogenesis of AOM is attributed to a variety of well-established internal and extrinsic factors. Recent evidence strongly points to bacterial biofilm formation as an important contributor to this disease entity. The nasopharynx is a likely reservoir for infection with subsequent seeding of pathogens to the middle ear via planktonic shedding. Various modalities have been used to directly detect biofilm formation in the middle ear mucosa of children with AOM. Further insights into this disease may lead to new strategies for prevention and treatment.
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Affiliation(s)
- James Mark Coticchia
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine , Detroit, MI , USA
| | - Michael Chen
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine , Detroit, MI , USA
| | - Livjot Sachdeva
- Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine , Detroit, MI , USA
| | - Sean Mutchnick
- Wayne State University School of Medicine , Detroit, MI , USA
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