Abstract

Otitis media (OM) is a common ear infection and a leading cause of conductive hearing loss in the pediatric population. Current technologies such as otoscopy, pneumatic otoscopy, tympanometry, and acoustic reflectometry are used to diagnose OM, which can reasonably diagnose the infection with a sensitivity and specificity of 50–90% and 60–90%, respectively. However, these techniques provide limited information about the physical architecture of the tympanic membrane (TM), or what may lie behind it. Here, we report the detection of nanometer-scale structural changes of the TM using nano-sensitive optical coherence tomography (nsOCT). In total, an image dataset from 65 pediatric subjects from three different groups (normal, acute OM, and chronic OM) and with longitudinal image-based analysis of ear infections were included in this study. The nsOCT data were correlated with physician diagnosis and with OCT thickness measurements and were found to be in good agreement with these results. We report that nsOCT detects in vivo structural deformations of the TM earlier than OCT alone, and enhances the detection sensitivity of OCT measurements. This unique technique for early detection of nano-scale structural modifications in the TM has the potential to aid in our understanding of microbiological effects, and possibly for early diagnosis and more effective treatment of OM.

Highlights

  • Background noise levelIntensity above background Sound level 1 Sound level 2by averaging of the spatial period values within each region of interest (ROI)

  • We report in vivo nano-scale structural changes in the tympanic membrane (TM) of a cohort of pediatric human subjects, as well as track the structural changes during a longitudinal study of subjects undergoing surgical intervention for chronic Otitis media (OM)

  • A multilayered tape phantom placed on a stack of lead zirconate titanate (PZT) (PE4, AE0505D16F, Thorlabs) was imaged with known displacements to determine if nanosensitive optical coherence tomography (nsOCT) processing was sensitive to axial motion of the sample

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Summary

Results

The calculated mean spatial period for the two different sound intensities across the range of frequencies showed similar spatial periods (difference 0 nm, uncertainty 1 nm) and suggested that the nsOCT processing and results are not sensitive to axial displacement of an in vivo TM. Both experiments confirm our hypothesis that nsOCT is only sensitive to axial structural changes and not to the axial displacement of the. A square region of interest (ROI) approximately 200 × 200 pixels from each nsOCT image was manually selected, followed

Background noise level
Discussion and Conclusion
Materials and Methods

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