Editors' ChoiceEAR INFECTION

Seeing an Earful

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Science Translational Medicine  13 Jun 2012:
Vol. 4, Issue 138, pp. 138ec104
DOI: 10.1126/scitranslmed.3004425

Otitis media (OM)—usually referred to as middle ear infections—are extremely common but are challenging to diagnose and treat in both children and adults. OM is defined by inflammation of the middle ear, often caused by bacteria and viruses, yet confirming OM is not easy: Redness of tissue and perceived swelling of the eardrum observed with an otoscope do not always correspond with actual infection. In response, Nguyen and colleagues have developed a noninvasive imaging technique that may improve diagnosis of bacterial OM.

The authors adapted two related light-based technologies called optical coherence tomography (OCT) and low-coherence interferometry (LCI) to image surface-attached bacterial biofilms on the eardrum. OCT and LCI work by distinguishing the wave properties and scattering of light, in which the light distribution recorded from behind the eardrum is reconstructed into an image of bacteria that are present. Using these OCT and LCI instruments, the authors were able to see the thin biofilm’s microstructure and, in turn, successfully distinguish bacterial growth on the eardrum membrane of 13 adults with chronic OM compared with seven healthy controls.

Most cases of OM are mild and can be cured by a healthy immune system. But for those with persistent inflammation, this approach by Nguyen et al. may represent a major step forward in the diagnosis of ear infections, which would improve treatment. Importantly, confirming the presence of a bacterial infection (as opposed to viral) would prevent unnecessary prescription of antibiotics. An additional challenge to ear infections? Correctly identifying the causative bacterial species and understanding biofilm growth over time—two considerations the authors plan to tackle with their noninvasive technology.

C. T. Nguyen et al., Noninvasive in vivo optical detection of biofilm in the human middle ear. Proc. Natl. Acad. Sci. U.S.A., 29 May 2012 (10.1073/pnas.1201592109). [Abstract]

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