title: Noninvasive depth-resolved optical measurements of the tympanic membrane and middle ear for differentiating otitis media.
abstract: OBJECTIVE
  In this study, optical coherence tomography (OCT) is used to noninvasively and quantitatively determine tympanic membrane (TM) thickness and the presence and thickness of any middle-ear biofilm located behind the TM. These new metrics offer the potential to differentiate normal, acute, and chronic otitis media (OM) infections in pediatric subjects.
  
  
  METHODS
  Case series with comparison group.
  
  
  METHODS
  The TM thickness of 34 pediatric subjects was acquired using a custom-built, handheld OCT system following a traditional otoscopic ear exam.
  
  
  RESULTS
  Overall thickness (TM and any associated biofilm) was shown to be statistically different for normal, acute, and chronic infection groups (normal-acute and normal-chronic: P value < 0.001; acute-chronic: P value = 0.0016). Almost all observed scans from the chronic group had an accompanying biofilm structure. When the thickness of the TM and biofilm were considered separately in chronic OM, the chronic TM thickness correlated with the normal group (P value = 0.68) yet was still distinct from the acute OM group (P value < 0.001), indicating that the TM in chronic OM returns to relatively normal thickness levels.
  
  
  CONCLUSIONS
  Identifying these physical changes in vivo provides new metrics for noninvasively and quantitatively differentiating normal, acute, and chronic OM. This new diagnostic information has the potential to assist physicians to more effectively and efficiently screen, manage, and refer patients based on quantitative data.
  
  
  METHODS
  4.
authors.affiliation: Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.|Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.
authors.forename: Guillermo L
authors.initials: GL
authors.lastname: Monroy
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Shelton
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Nolan
authors.affiliation: Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.|Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.
authors.forename: Cac T
authors.initials: CT
authors.lastname: Nguyen
authors.affiliation: Department of Surgery, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.|Department of Otolaryngology, Urbana, Illinois, U.S.A.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Novak
authors.affiliation: Department of Pediatrics, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.|Department of Pediatrics, Urbana, Illinois, U.S.A.
authors.forename: Malcolm C
authors.initials: MC
authors.lastname: Hill
authors.affiliation: Carle Foundation Hospital, Urbana, Illinois, U.S.A.|Advanced MEMS, San Francisco, California, U.S.A.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: McCormick
authors.affiliation: Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.|Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.|Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.|Department of Internal Medicine, College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, U.S.A.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Boppart
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D004432:Ear, Middle / Q000473:pathology*; D006801:Humans; D010033:Otitis Media / Q000175:diagnosis*; D010045:Outpatients; D041623:Tomography, Optical Coherence / Q000379:methods*; D014432:Tympanic Membrane / Q000473:pathology*
keywords: Otitis media; biofilm; optical coherence tomography; otolaryngology; pediatric