MEPD after TT insertion

TT 插入后的 MEPD

• 批准号: 7914273
• 负责人: ELLEN M MANDEL
• 金额: $ 12.96万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7914273
• 关键词: 3 year old; Bolus Infusion; Bypass; Child; Clinical; Clinical Research; Constitutional; Data; Disease; Ear; Economic Inflation; Edema; Enrollment; Equilibrium; Eustachian Tube; Feedback; Frequencies; Functional disorder; Gases; Healed; Health; Individual; Inflammation; Longitudinal Studies; Measurement; Measures; Medical; Methods; Modeling; Mucous Membrane; Noble Gases; Otitis Media; Otitis Media with Effusion; Otorrhea; Pathogenesis; Patient observation; Patients; Phase; Protocols documentation; Recurrence; Regulation; Resolution; Risk; Testing; Time; Tube; Tympanostomy; Tympanostomy Tube Insertions; aged; disorder prevention; effusion; expectation; healing; longitudinal human study; mathematical model; middle ear; pressure; prevent; theories

MIDDLE EAR PRESSURE DEREGULATION AFTER TYMPANOSTOMY TUBE INSERTION Perhaps the most well supported clinical evidence for our model of Otitis Media with Effusion (OME) pathogenesis by middle ear (ME) pressure disregulation is the documented positive effect of tympanostomy tube (TT) insertion in preventing and resolving OME episodes. Because TTs bypass the Eustachian tube (ET) to maintain ambient ME pressure, these observations suggest that adequate ME pressure-regulation and not other suggested functions of the ET is prerequisite for disease resolution. Longitudinal studies show that after TT insertion in MEs with OME, the volume of the ME airspace progressively increases which correlates with decreasing ME inflammation and effusion volume. Our mathematical model shows that these changes should be reflected as lesser rates of gas exchange across the ME mucosa which are realized as a decreased demand placed upon the ET for gas resupply. In the proposed study, we will enroll children aged 3 years and older with TTs inserted for OME and measure the ME gas demand, ME volume and ETF longitudinally between TT insertion and extrusion, and then follow the enrolled patients for disease recurrence after TT extrusion. These results will be used to test the hypotheses that: 1) gas transfer across the ME mucosa (MEM) decreases in phase with resolution of ME inflammation and effusion; 2) gas transfer across the MEM is increased by an episode of otorrhea; 3) ETF is unaffected by TT insertion, and 4) measurement of ETF and transMEM gas transfer (supply/demand balance) predicts disease recurrence and presentation after TT extrusion. The results of these studies will be used to support or refute tested components of our model of ME pressure-regulation and to develop test protocols for risk assignments with respect to disease recurrence in individual ears after TT extrusion.

鼓膜造口管插入后中耳压如果 也许我们以积液（OME）模型的最受支持的临床证据（OME） 中耳的发病机理（ME）压力不调节是鼓膜造口管的证明的积极作用 （TT）插入预防和解决OME发作时。因为TT绕过Eustachian Tube（ET） 维持环境压力，这些观察结果表明，我的压力调节足够 ET的建议功能是疾病解决的先决条件。纵向研究表明，TT之后 用OME插入MES，ME空域的体积逐渐增加，与 减少我的炎症和积液量。我们的数学模型表明这些更改应该 反映是在ME Mucosa中较小的气体交换率，这被认为是需求减少 放在ET上以进行气体补给。在拟议的研究中，我们将注册3岁及以上的儿童 插入OME的TT并测量ME气体需求，ME数量和ETF在TT之间纵向 插入和挤出，然后跟随入学的患者进行TT挤出后​​的疾病复发。这些 结果将用于测试：1）跨ME粘膜（MEM）的气体转移在 阶段与我的炎症和积液解决； 2）通过 Otorrhea的情节； 3）ETF不受TT插入的影响，4）测量ETF和TransMem气体 转移（供需平衡）预测TT挤出后​​疾病复发和表现。结果 这些研究将用于支持或反驳我们的压力调节模型的经过测试的组件 开发针对TT之后各个耳朵疾病复发的风险分配的测试方案 挤压。