ULTRASONIC DETECTION OF MIDDLE EAR EFFUSION

描述（由申请人提供）：误诊中耳炎（OM）是儿童抗生素过度用药的主要原因。不必要使用抗生素的惊人后果是导致OM的细菌菌株对抗生素的耐药性不断增加。目前可用的中耳积液无创检测方法的准确性并不令人满意，特别是当该测试由初级卫生保健提供者执行时。在第一阶段，我们通过分析鼓膜和中耳腔反射的超声回波，证明了无创检测中耳积液的可行性。我们的超声方法与鼓膜切开术在检测积液和区分浆液和黏液状态方面具有统计学意义（P = 0.004）。在第二阶段，我们建议开发一种改进的超声探头和分析软件，以实现对中耳积液的无创检测和对占据中耳的液体粘度的估计。后一种特性是任何现有的非侵入性检测方法都无法提供的。

DESCRIPTION (provided by applicant): Misdiagnosed otitis media (OM) is a leading cause of overmedication with antibiotics in children. The alarming consequence of unnecessary antibiotic use is increasing resistance to antibiotics among bacterial strains responsible for OM. The accuracy of currently available noninvasive detection methods of middle ear effusion is not satisfactory, especially when the test is performed by primary health care providers. In Phase I we demonstrated the feasibility of noninvasive detection of middle ear effusion based on the analysis of ultrasonic echoes reflected from the tympanic membrane and the middle ear cavity. We achieved a statistically significant (P = 0.004) correlation between our ultrasonic method and myringotomy in the detection of the effusion and in differentiation between serous and mucoid states of the fluid. In Phase II, we propose development of a refined ultrasonic probe and analysis software to allow noninvasive detection of middle ear effusion and the estimation of the viscosity of the fluid occupying the middle ear. This latter feature is not available with any existing noninvasive detection method. We will develop a miniature ultrasonic curved array transducer, which will be incorporated into an earplug (probe). The probe will allow for fast acquisition of ultrasonic scans from the ear canal and middle ear cavity. Designated software, which will be developed in this project, will extract diagnostically significant features of the scan and it will display the result in easy for interpretation format. The device we propose will allow diagnostic testing on conscious pediatric patients in the average medical office setting and will provide information for accurate diagnosis of middle ear effusion.