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，NIH资助的临床研究中心，专注于中耳（ME）压力（MEP）调节的生理学。整合的主题是MEP失调（MEPD）在中耳炎（OM）伴积液（OME）发病机制中的作用。我们请求NIH 5年的支持来进一步发展这个研究主题。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调节方法的诊断效用，探索可能调节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是一项持续5年的随访研究的延续，对三组儿童进行随访，这些儿童在3岁时患有慢性OME，复发性急性OM或无明显OM。对于每一组，我们跟踪儿童至7-8岁，使用标准化测试方案和定期测量耳咽管(ET)/ME系统的解剖结构，反复评估mep调节。这些数据将用于定义各组在各年龄段ET/ME解剖结构和功能的差异，各组随着生长发育解剖结构和功能的变化，以及解剖底物对功能的影响。目的是确定是否有任何解剖或功能指标可以预测分组分配，以及是否有任何指标可以预测某一特定儿童的未来病程。项目5继续我们对正常和患病MEs的mep调节建模的工作。这些模型用于开发功能-解剖关系，以帮助解释项目数据并定义OME的可能治疗方案。核心A管理中心，指导其未来发展方向，并为所有项目提供数据录入和统计服务。核心B开发新的测试、协议和仪器，以评估环境保护法规，并提供三个项目所需的所有测试/成像服务。该临床研究中心在关注mep调控和mep在OME发病机制中的作用方面是独一无二的。

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.