Optical Coherence Tomography (OCT) has shown its detection and diagnostic capabilities for otitis media (OM), enabling visualization through scattering tissues including the tympanic membrane and biofilms, and into the middle ear cavity. Preliminary results from an ongoing five-year 235-subject study at Children’s Wisconsin, Medical College of Wisconsin, are presented. A vision-language machine learning model was trained on OCT image features and clinical metadata to differentiate OM disease states and predict required interventions. This study demonstrates the prognostic value of OCT in assessing OM and offers the potential for improving the management of patients with OM.
SignificanceEndotracheal intubation is a common approach for airway management in critically ill patients. However, the position of the endotracheal tube (ETT) may be altered during the procedure due to head movements. Accidental displacement or dislodge of the ETT may reduce the airflow, leading to moderate to severe complications, and in some cases even fatality. Therefore, timely detection of changes in ETT position in the trachea is critical to ensure immediate and intermediate interventions to maintain the ETT in the proper position. Currently, there are no widely utilized tools for real-time monitoring of ETT positions.AimThe goal of this study is to develop a cost-effective and easy-to-use near-infrared (NIR) device, named Opt-ETT, capable of continuously monitoring the ETT position in the trachea of a patient.ApproachA side-firing fiber is attached to the side of the ETT to illuminate the trachea tissue with NIR light, and a detector board containing five phototransistors is affixed to the chest skin to measure the intensity of diffusely transmitted light. Displacement of the ETT is estimated using second-order polynomial fitting to the ratios of the phototransistor readings. Monte Carlo simulations, ex vivo experiment on porcine tissue, and in vivo experiments using a swine model have been conducted to assess the feasibility of the device.ResultsThe design of the Opt-ETT device has been verified by the Monte Carlo simulations and ex vivo experiment. The estimation of displacement from in vivo experiments using the Opt-ETT exhibited a high degree of agreement with that measured by a reference sensor, with a discrepancy between −1.0 to +1.5 mm within a displacement range from −15 to +15 mm.ConclusionsThe Opt-ETT device provides a potentially cost-effective solution for real-time and continuous monitoring of ETT position in patient during an intubation procedure.
To non-invasively assess the impact of antibiotic therapy on otitis media (OM), a handheld OCT system was developed to longitudinally monitor in vivo middle ear conditions of OM-induced chinchilla models. The formation of middle ear effusions (MEEs) and biofilm were examined over the course of the infection. Furthermore, the effect of antibiotics on the biofilm as well as the amount and type of MEEs was investigated with low-dose and high-dose antibiotics (ceftriaxone). Quantitative parameters, such as TM thickness and effusion and biofilm scattering/texture, were correlated with histology and fluorescence in situ hybridization (FISH) at the end time point.
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