Purpose To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology. Materials and Methods This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pressure equalization tube placement were enrolled. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings of middle ear contents were analyzed by computer algorithm. Middle ear fluid was collected during myringotomy and analyzed for bacterial culture and viscosity. Results Ultrasound waveforms yielded a computer algorithm interpretation of middle ear contents in 66% of ears tested. When a result was obtained, the sensitivity and specificity for successfully characterizing middle ear fluid content as either void of fluid, thick fluid (mucoid), or thin fluid (serous or purulent) was at least 94%. Mucoid effusions had higher measured viscosity values (P=0.002). Viscosity measures were compared to culture result, and those with low viscosity (thin consistency) had a higher likelihood of having a positive culture (P=0.048). Conclusion The device sensitivity and specificity for fluid detection was 94% or greater among interpretable waveforms (66% of those tested). Although this technology provides important information of the middle ear effusion presence and characteristic, further technological improvements are needed.

The paper presents design and development of a precision motion actuator, which can traverse required trajectory in the X–Y plane and can be used for micromachining applications using magnetic levitation based technology. A glass-reinforced epoxy laminate sheet with micromachined holes in the horizontal and vertical direction with copper wires placed vertically and horizontally was used for actuation of rare earth magnets wherein a pyrolytic graphite sheet was fixed over the copper wires. The diamagnetism of pyrolytic graphite sheet coupled with electromagnetic field generated because of the current passing through the copper wires led to levitation and actuation of the rare earth magnet over desired trajectory. COMSOL Multiphysics (COMSOL Inc., Burlington, Massachusetts, USA) simulation was conducted in order to simulate the forces generated by the developed actuator. Thereafter, the forces generated by the actuator with current flowing through the wires were measured using a dynamometer where the error was limited within 2%. An acrylic sheet was fixed over the actuator and laser micromachining was conducted with trajectories traversed by the actuator. Scanning electron microscope results of the machined samples confirmed that feature sizes in the range of 200–300 micron could be generated. This proves the potential of the developed actuator for micromachining applications.

Purpose-To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology.Materials and Methods-This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pressure equalization tube placement were enrolled. With the child anesthetized, the probe was placed into the external ear canal after sterile water was inserted. Ultrasound recordings of middle ear contents were analyzed by computer algorithm. Middle ear fluid was collected during myringotomy and analyzed for bacterial culture and viscosity.Results-Ultrasound waveforms yielded a computer algorithm interpretation of middle ear contents in 66% of ears tested. When a result was obtained, the sensitivity and specificity for successfully characterizing middle ear fluid content as either void of fluid, thick fluid (mucoid), or thin fluid (serous or purulent) was at least 94%. Mucoid effusions had higher measured viscosity values (P=0.002). Viscosity measures were compared to culture result, and those with low viscosity (thin consistency) had a higher likelihood of having a positive culture (P=0.048). Conclusion-The device sensitivity and specificity for fluid detection was 94% or greater among interpretable waveforms (66% of those tested). Although this technology provides important information of the middle ear effusion presence and characteristic, further technological improvements are needed.

Objectives: (1) Appreciate the current diagnostic limitations and significant misinterpretation rate (nearly 50%) of acute otitis media (AOM) and otitis media with effusion (OME) by general practitioners and pediatricians using the conventional otoscope. (2) Recognize the optical properties of middle ear effusion (MEE) and this innovation’s ability to improve diagnosis using a concentrated (laser) light. Methods: Laser otoscopes were developed and designed with class IIIa lasers. The laser propagates with the incandescent light to illuminate on the tympanic membrane (TM). An institutional review board–approved prospective pilot study was completed at a tertiary care hospital. Study patients were 1 to 18 years and undergoing ear tube placement. The laser otoscope was used on each ear for assessment of MEE prior to myringotomy. The simple objective presence or nonpresence of a glow of the laser on the TM surface was recorded. Presence of a glow signified MEE due to the dispersion quality of light through liquid versus air. True presence of MEE was then determined with myringotomy. Results: Fifty ears (25 patients) were enrolled. Assessing only for a simple objective glow without any further interpretation of the middle ear contents yielded an 89.4% accuracy for determining MEE. Conclusions: The laser otoscope is a novel, simple, and potentially extremely useful tool for assisting in otoscopic determination of fluid in the middle ear. Particularly among primary care givers, MEE assessment may be able to be increased from nearly 50% to nearly 90%, by simply assessing for a laser glow or no-glow on the TM surface.

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