Duke researchers develop device to screen for infection-related hearing loss

To combat the high rates of infection-related hearing loss in rural, underserved communities in the United States, a cohort of Duke biomedical engineering students, led by Mark Palmeri, professor of the practice in biomedical engineering and anesthesiology, in collaboration with surgery and audiological faculty now at the University of Arkansas for Medical Sciences have developed mobile health screening technology to detect middle ear disease that frequently leads to hearing loss. 

The project developed a new tympanometer, a device traditionally deployed to identify middle ear diseases, including infections. Conventional tympanometers are expensive and their results are typically interpreted by expert audiologists. Some residents from remote communities cannot access expert audiologists.

Researchers aimed to make the technology more accessible by creating a smartphone-compatible, user-friendly tympanometer, so that patients will be able to interpret results without the assistance of an audiologist. 

Samantha Kleindienst Robler, assistant professor at UAMS and population health researcher at NSHC, said the idea for the new medical technology emerged because “tympanometry is necessary” to improve “the accuracy of screening programs in rural areas,” but it has not been possible because currently there is not an “easy-to-use screening, portable and cheap version available.” 

According to Robler, rural communities experience disproportionate exposure to preventable ear infections because of factors that may include inadequate access to healthcare and clean running water, conditions of crowded living and increased exposure to secondhand smoke. 

 “If we can create a tool, using tympanometry, that makes screening possible in terms of hearing and looking for infection-related causes, then the impact there is huge because that's where the need is," Robler said. "We know that when kids don't have early detection and intervention, then it leads to vocational issues, poor academic performance, poor social-emotional development and a poor quality of life." 

Currently, the tympanometer is in its prototype phase, and the researchers anticipate developing it into a fully functional device in the coming months. 

Once the device is complete, with the assistance of a National Institute of Health grant, the team will conduct a validation study with the product in rural regions of South Africa, according to Palmeri. The validation study will begin in 2023 and researchers hope the device will be made publicly available in the future. 

At the project’s inception, Susan Emmett, former associate professor of surgery and global health at Duke School of Medicine and current associate professor of otolaryngology and public health at UAMS, partnered with Robler with the goal of increasing access to screening technology among under-resourced communities. Later, the pair reached out to Palmeri to establish a collaboration with biomedical engineering to develop this device. 

In spring 2020, Emmett and Palmeri applied for seed funding from Duke MEDx, a joint program between the Pratt School of Engineering and the School of Medicine. Her team received a grant from MEDx, supplemented by various other internal funding sources. 

Palmeri recruited a group of graduate and undergraduate students to join the team. They have since been working on design improvement and prototype testing.

“I think another huge part about this [project] is that we're breaking the mold on something that is mostly being driven by student power, ideas and skills, and that's just awesome,” Palmeri said.

Correction: An earlier version of this article incorrectly stated that the device diagnosed hearing loss. It has been corrected to reflect that the device screens for middle ear disease to support the identification of infection-related hearing loss. An earlier version incorrectly referred to Mark Palmeri as Mike Palmeri. An earlier version also incorrectly stated the members of the development team, including Samantha Kleindienst Robler, as participating in the project as employees of Norton Sound Health Corporation. It has been corrected to reflect that while Robler works at NSHC, she is also affiliated with University of Arkansas for Medical Sciences. An earlier version incorrectly stated that Robler said low-income communities experienced disproportionate exposure to preventable ear infections; it has been corrected to reflect she said rural communities. An earlier version incorrectly stated that the device would be integrated into clinical research trials in 2023; it has been corrected to reflect that the team will conduct validation studies then. An earlier version also incorrectly stated that Susan Emmett was a current associate professor at Duke School of Medicine. It has been corrected to reflect that Emmett formerly worked at Duke and currently works at UAMS. The Chronicle regrets the errors.

Halle Friedman | Associate News Editor

Halle Friedman is a Trinity senior and an associate news editor of The Chronicle's 119th volume.


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