Middle Ear Pressure Regulation in Health and Disease

描述(由申请人提供)：在过去的6年里，我们建立了一个独特的，由NIH资助的，专注于中耳(ME)压力(MEP)调节的生理学临床研究中心。综合主题是MEP失调(MEPD)在渗出性中耳炎(OME)发病机制中所起的作用。我们要求NIH提供5年的支持，以进一步发展这一研究主题。我们包括由两个核心支持的三个项目。项目1评估健康和疾病期间的MEP调节，定义当前和新开发的评估MEP调节的方法的诊断效用，探索潜在调节MEP调节的生理机制，并开始将这些测试和结果转移到临床环境中。项目2是对三组儿童的持续5年跟踪调查的继续，这些儿童在3岁时有记录在案的慢性OME、复发性急性OM或无明显OM的病史。对于每一组，我们跟踪观察到7-8岁的儿童，使用标准化的测试方案和咽鼓管(ET)/ME系统的定期解剖测量反复评估MEP调节。这些数据将被用来确定不同年龄组之间ET/ME解剖和功能的差异，每个组随着生长发育而发生的解剖和功能变化，以及解剖底物对功能的影响。其目的是确定是否有任何解剖学或功能测量预测分组分配，以及是否有任何测量预测给定儿童的未来病程。项目5继续我们对正常和疾病MES的MEP调节进行建模的工作。这些模型被用来发展功能-解剖关系，帮助解释项目数据，并定义OME可能的治疗方案。核心A负责管理该中心，指导其未来方向，并为所有项目提供数据输入和统计服务。核心B开发新的测试、协议和工具来评估MEP法规，并提供三个项目所需的所有测试/成像服务。这个临床研究中心的独特之处在于它专注于MEP的调节以及MEPD在OME发病机制中所起的作用。

DESCRIPTION (provided by applicant): Over the past 6 years, we have established a unique, NIH funded, Clinical Research Center focused on the physiology of middle ear (ME) pressure (MEP) regulation. The integrating theme is the role played by MEP disregulation (MEPD) in the pathogenesis of otitis media (OM) with effusion (OME). We are requesting 5 years of NIH support to further develop this research theme. We include three Projects supported by two Cores. Project 1 evaluates MEP-regulation during health and disease, defines the diagnostic utility of current and newly developed methods to assess MEP-regulation, explores those physiological mechanisms that potentially modulate MEP-regulation and initiates the transfer of these tests and results to the clinical environment. Project 2 is a continuation of an ongoing, 5-year follow-up of three groups of children who were entered at 3 years of age with a documented history of chronic OME, recurrent acute OM or no significant OM. For each group, we are following the children to 7-8 years of age with repeated evaluations of MEP-regulation using standardized test protocols and periodic measures of the anatomy of the Eustachian tube (ET)/ME system. These data will be used to define the differences in ET/ME anatomy and function between groups at each age, the changes in anatomy and function for each group with growth and development, and the effect of the anatomical substrate on function. The goals are to determine if any anatomic or functional measure predicts group assignment and if any of the measures predict the future course of disease in a given child. Project 5 continues our work on modeling MEP-regulation for normal and diseased MEs. These models are used to develop functional-anatomic relationships, to aid in the interpretation of data from the Projects and to define possible treatment options for OME. Core A administers the Center, guides its future direction and provides data entry and statistical services to all Projects. Core B develops new tests, protocols and instruments to assess MEP-regulation and provides all testing/imaging services required by the three Projects. This Clinical Research Center is unique in its focus on MEP-regulation and the role played by MEPD in OME pathogenesis.