Ultrasound characterization of middle ear effusion.
OBJECTIVE
To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology.


METHODS
This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pressure equalization tube placement were enrolled. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings of middle ear contents were analyzed by computer algorithm. Middle ear fluid was collected during myringotomy and analyzed for bacterial culture and viscosity.


RESULTS
Ultrasound waveforms yielded a computer algorithm interpretation of middle ear contents in 66% of ears tested. When a result was obtained, the sensitivity and specificity for successfully characterizing middle ear fluid content as either void of fluid, thick fluid (mucoid), or thin fluid (serous or purulent) were at least 94%. Mucoid effusions had higher measured viscosity values (P=.002). Viscosity measures were compared to culture result, and those with low viscosity (thin consistency) had a higher likelihood of having a positive culture (P=.048).


CONCLUSIONS
The device sensitivity and specificity for fluid detection were 94% or greater among interpretable waveforms (66% of those tested). Although this technology provides important information of the middle ear effusion presence and characteristic, further technological improvements are needed.
Head and Neck Institute, Cleveland Clinic, Cleveland, OH, USA.
Rahul
R
Seth
Christopher M
CM
Discolo
Grazyna M
GM
Palczewska
Jan J
JJ
Lewandowski
Paul R
PR
Krakovitz
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004432:Ear, Middle / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods*; D010034:Otitis Media with Effusion / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D014463:Ultrasonography