In Vivo Optical Characterization of Middle Ear Effusions and Biofilms During Otitis Media

Area of Science:

• Biomedical Optics
• Medical Imaging
• Otolaryngology

Background:

• Otitis media (OM) involves middle ear effusion (MEE), crucial for management but difficult to assess non-invasively.
• Current diagnostic tools struggle to visualize MEE behind the eardrum.
• Bacterial biofilms within MEE contribute to OM pathogenesis and treatment resistance.

Purpose of the Study:

• To develop and validate a non-invasive optical coherence tomography (OCT) system for visualizing and characterizing MEE and biofilms.
• To create an atlas of in vivo middle ear OCT images for OM assessment.
• To correlate OCT findings with surgical evaluations for improved diagnostic accuracy.

Main Methods:

• A portable, handheld OCT system integrated with an otoscope was developed.
• In vivo OCT imaging was performed on 53 pediatric OM patients prior to ear tube surgery.
• OCT data was compared with ex vivo MEE analysis, clinical diagnosis, and post-operative outcomes.

Main Results:

• The OCT system successfully visualized MEE and depth-resolved features.
• 89.6% of subjects with MEE showed TM-adherent biofilms on in vivo OCT.
• Quantitative OCT metrics correlated significantly with surgical MEE evaluations.

Conclusions:

• OCT offers a non-invasive method to visualize and characterize middle ear effusion and biofilms in pediatric otitis media.
• This technology can provide valuable data for improved diagnosis and management strategies.
• The developed OCT system and image atlas represent a significant advancement in OM diagnostics.