What Are Ear Tubes?

As a parent, you always want to have the answers. You have a tiny human being that has to depend on you for all of his or her needs. You helped create this smiling bundle of joy and you want to put him or her on the best possible track for success; however, some things happen that are outside of your control and expertise. One of those things that commonly affect infants and small children is an ear infection. 

Eight out of 10 children will have a middle ear infection, but what if your child seems to have them more than what you think is normal? What if your child seems to have difficulty hearing and complains about “water in the ear” when there doesn’t seem to be a reason for it? When this happens, it may be time to seek help by calling your primary care doctor or ENT specialist for the best next steps for your child’s ear health.

WHAT ARE EAR TUBES? 

Ear tubes go by many names – myringotomy tubes, tympanostomy tubes, ventilation tubes – but they’re all the same thing. They are small, hollow tubes made of plastic or metal that are surgically inserted into an incision in your child’s eardrum. This procedure creates an opening that allows air ventilation of the middle ear, drains any fluid present, and stops the buildup of fluid behind the eardrum. By doing this, the risk of ear infections is mitigated and, as long as the tube stays in place without clogging, the child should not experience any further ear infection-related issues. But even knowing what ear tubes accomplish can still leave some unanswered questions, such as; “How do I even know if my child needs them or not?”

WHEN A CHILD MAY NEED EAR TUBES

Ear tubes are most commonly used in children because their eustachian tubes – the natural ventilation structure of the middle ear – are narrower and more horizontal than in a grown adult. When children develop an upper respiratory infection, the resulting mucus can more easily block the eustachian tubes, which causes an accumulation of fluid in the middle ear. When this problem persists for more than three or four months following an ear infection, it may be time for tubes to be placed in your child’s ears. 

Other symptoms that may precede the need for ear tubes are the following:

• Repeated ear infections that do not improve with medications over several months
•  Fluid in the ears and more than 3 months hearing loss
• Speech and language development delays

RISKS ASSOCIATED WITH EAR TUBES

Before making the commitment to getting this surgery for your child, do not be afraid to ask about the risks and benefits of the procedure. 

While all types of surgeries in which general anesthesia is used carry a risk, the procedure for placing ear tubes in the eardrum is a relatively quick, safe and effective procedure. However, outcomes may vary. Just because a child receives tubes does not mean he or she can never contract an infection again. There is also the potential risk of scarring or weakening of the eardrum or the tubes staying in too long or falling out early; however, the benefits of receiving tubes generally outweigh the risks.

By receiving the ear tube placement procedure, the child’s risk of future ear infections are lowered and hearing can be restored if one of the symptoms prior to the surgery was hearing loss. Also, speech development can continue on as normal and even the child’s sleep, behavior and communication may be improved if previous ear infections affected one or all of those areas. Finally, the ear tubes will allow time for the child to mature and will help his or her eustachian tube to work more efficiently as it becomes wider and longer.

Finally, after surgery has been completed and the tubes are safely inside your child’s ear, the next step is simply to care for your little one. Antibiotic ear drops and/or pain killers may be prescribed, and your healthcare provider will provide any special post-surgery care instructions. If you notice any drainage, ear pain, or fever after the procedure, you should call your child’s healthcare provider. If all things go according to plan, the tubes should fall out on their own after approximately six to nine months.

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Talking About Ear Tubes with Dr. Michael Novak

Eight out of 10 children will have a middle ear infection, but what if your child seems to have them more than what you think is normal? What if your child seems to have difficulty hearing, and complains about “water in the ear” when there doesn’t seem to be a reason for it? When this happens, it may be time to seek help by calling your primary care doctor, who may refer you to an ENT specialist, for the best next steps for your child’s ear health. 

For some children, the next best step in managing your child’s ear health is the placement of tubes within the eardrum, also known as tympanostomy tubes. About 700,000 children each year have ear tubes surgically placed t, according to the American Academy of Otolaryngology-Head and Neck Surgery. Ear tubes typically cost around $2-5,000, most of which is usually covered by insurance. The surgery does carry some risk, partly because the child will be put under general anesthesia. 

We sat down with Dr. Michael Novak, an Ear, Nose and Throat doctor from Carle Foundation Hospital in Urbana, Illinois, to chat more about ear tubes and specifically why the fall and winter months are a common time for placement of ear tubes.

What are the common reasons for tube placement in children?
Tubes are generally placed in children to treat frequent infections (4 or more over a 6 month period) or persistent fluid in the middle ear (fluid that stays in the ear for at least 3 months).

If a child is a candidate for this type of surgery, why are the fall and winter months the most common time for tube placement?
The most common times for tube placement are late fall and early winter since the infections and fluid typically are caused by colds and flu. It may take 3 months or more to determine that a child is prone to ear infections and would benefit from tubes. The pattern of frequent infections tends to start in the late summer or early fall when kids get back into school and start sharing viruses, and we are indoors where colds can be communicated more easily. 

Is there immediate relief for the child after the tubes are placed?
Yes, the relief of the infection and removal of fluid gives immediate relief from pain and hearing loss. The improvement continues over 2-3 days as the ear returns to normal.

What are the general instructions and follow-up care for ear tubes?
I tell my patients to where ear plugs when they are swimming in lakes and rivers where   the water is not as clean as the swimming pool or shower. Otherwise, there are no special precautions necessary for the great majority of children. If drainage from the ear develops, it is treated with topical antibiotic and corticosteroid drops, and usually clears up quickly.

Thank you Dr. Mike for the fantastic insight regarding ear tubes – paying attention to the frequency and time of year of ear problems are key to a successful outcome!  

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PhotoniCare in the Land of the Rising Sun

By Ryan Shelton, CEO and co-founder

Some of you may have seen the press release that PhotoniCare has entered a distribution agreement to bring our middle ear imaging device to the Japanese market. I’ve since had some questions about this, given that we are still an early stage company that has yet to launch our product in the U.S. market. There are a couple of reasons we chose to enter into a partnership in Japan at this stage. I thought I’d share some of my thoughts here.

First, Japan is a strong medical device market. Although potentially more difficult to navigate than many EU markets, if you have the right partners it is a pro-technology market that highly values improved patient care. Furthermore, with regard to ear infections, the front-line defense is often the ENT specialist, not primary care. This changes the care pathway and market dynamics a bit, resulting in a large patient volume with acute diagnostic needs on the doorstep of specialist physicians. As a result, a technology like ours can be a very attractive solution to a call point that is more concentrated and approachable than other front-line care markets.

Second, we simply found a great partner. I have been very protective of our resources (both human and financial), and very careful not to spread us too thin. I think diluting focus during initial market launch is a cardinal sin in the world of startups, and especially in healthcare. As we all know, it is difficult to successfully market products or services in the healthcare space, and if you want to succeed, I believe you have to have a laser focus on an approachable market segment. This makes any early OUS (outside U.S.) strategy difficult for healthcare startups. However, in Adachi, we found an opportunity to enter the Japanese market with a partner that believes strongly enough in our product and our team to dedicate significant resources to a pre-market opportunity. Furthermore, when Adachi hosted us on a road show across Japan to meet with the top KOLs (key opinion leaders) in the ENT space, they demonstrated that: (1) they have excellent market access in the territory, and (2) the market pull for our product is very strong. There was so much value to us in this one road show. I encourage every startup team looking at a potential distribution partner to be hands on and adamant in vetting their potential partner’s market access and KOL relationships. We believe the work we did up front in this area will pay dividends down the road.

I would be remiss if I did not take a minute to opine on what beautiful culture and country exists in Japan. Everything from their relationship-driven business culture, to their incredible food, or their breathtaking historical sites is an absolute pleasure to experience. If I may make a few recommendations from the trips Ryan Nolan (my co-founder) and I took last fall:

Kyoto is beautiful. It is packed full of rich history with its shrines, gates, and temples. Definitely worth a visit.

Find a local and eat whatever they recommend. Our partners were kind enough to make several recommendations.

We had the best sushi one can imagine. Amazing skewered and grilled chicken parts of all kinds (yakitori), sea urchin, cabbage pizza (okonomiyaki), and even a few pieces of medium rare chicken that were touted as a special preparation (still wondering if that one was a joke on the gullible Americans…:)). It was quite delicious (and we never got sick)! Try ALL the food. It’s amazing.

If you find yourself in Tokyo, give Oedo Ayatori a try. This was our favorite restaurant experience of the entire trip! It offered excellent food with a mind-blowing presentation, and a super fun atmosphere including a 360-degree rotating grill…

We certainly recognize that in addition to all the hard work we have put in to build this relationship and close a deal, the real work (and fun!) is just beginning. We are excited for what the future holds for PhotoniCare and we look forward to improving the health and hearing outcomes for many children and adults across Japan…and eating well while doing so!

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The Real Cost of Ear Infections

Middle ear infections, or otitis media, are very common. So common, in fact, that 90% of children will suffer from an ear infection in their childhood. You may notice your child being more fussy than usual, tugging on their ear and grimacing, or complaining about a sharp pain in the ear. These are all common ear infection systems which often lead a parent to take their child to a healthcare provider. 

Because ear infections are the most common ailment among kids it can cost a significant amount to the consumer and the health care system. With healthcare expenses on scrutiny now more than ever, we break down the real cost for ear infections, and how our technology will empower healthcare providers to make better decisions, and reduce costs exponentially. 

By the Numbers
If a parent brings their child into the office to see a healthcare provider, hits to the pocketbook begin to escalate:

• A typical visit to a healthcare provider’s office costs between $25 and $250.
• Copays for office visits range from $5 and $75, depending on the insurance company.

In addition to an office visit, there are many parents who take their child for ear pain treatment to urgent care or the emergency room. Debt.org reported on an Annals of Internal Medicine study that found the average cost of an urgent care visit for three common illnesses — middle ear infection, pharyngitis and urinary tract infection — was $155. Other estimates place the average urgent care visit at anywhere from $71 to $125. There are also instances where a parent may take their child to the emergency room for ear pain. Debt.org reports that an average emergency room visit for ear pain can cost an average of $400. 

Antibiotics
Besides being so prevalent among children, ear infections are also the leading cause of antibiotic over-prescription and antibiotic resistance development. Antibiotics play an important role in fighting infection, but when prescribed inappropriately, such as for viral infections or a non-bacteria related middle ear problem, the correct course of treatment is delayed, and the potential for unrelated bacteria to develop resistance to the prescribed antibiotic(s) can become a problem. 

Antibiotics also come with a price tag for parents:

• Antibiotics typically prescribed for a bacterial ear infection, such as Amoxicillin, cost between $20 and $110 for a week’s treatment. 
• Copays for the prescription ranges from $5 to $50.

Devices like OtoSight Middle Ear Scope will allow your healthcare provider to image the contents of the middle ear– providing key access to the information needed for a correct diagnosis and the first step in being a good Antibiotic Steward and reducing costs, both to you and the healthcare environment! 

Surgery
For some children, the next best step in managing your child’s ear health is the placement of tubes within the eardrum. About 700,000 children each year have ear tubes surgically placed, according to the American Academy of Otolaryngology-Head and Neck Surgery. Ear tubes typically cost around $2,000-5,000 for people with insurance.  

Diagnosing Ear Infections
The American Academy of Pediatrics AOM guidelines state that fluid must be present in the middle ear to definitively diagnose Acute Otitis Media (AOM). This buildup of fluid and pressure in the middle ear is the direct result of a microbial infection that would, in many cases, be treated with antibiotics. However, determining if there is fluid in the middle ear is difficult today because the tools currently available measure or view the eardrum only, rather than measuring the potential fluid directly. In the current paradigm of care, the eardrum is observed as a proxy for middle ear health.

Current tools used to diagnose fluid in the middle ear can be difficult to use reliably in squirming or crying children, and rely heavily on user expertise to interpret a simple image or measurement of the eardrum. In the primary care setting, otoscopic accuracy has been reported to be as low as 50%. By the numbers, half of all children are not given an accurate diagnosis. The result? Increased costs for payers and over prescription of antibiotics for the patient. 

• Ear infections, in general, are responsible for $10 billion in related healthcare costs
• AOM  infections are the cause of 30 million office visits each year in the United States alone. 

PhotoniCare’s mission is to make a real impact on the health of children – that’s why we started with middle ear infections. Our goal with our first product, the OtoSight Middle Ear Scope, is to revolutionize the diagnosis, treatment, and monitoring of middle ear infections. 

The Future of Diagnosing Ear Infections
The technology harnessed by the OtoSight Middle Ear Scope is a quantum leap over the current standard, in that OtoSight Middle Ear Scope can actually see evidence of disease in the middle ear. All other technologies on the market are using the eardrum as a proxy to diagnose middle ear disease – this methodology is inherently problematic as it does not reflect accurately enough the actual condition of the middle ear. In other words, you get what you see – OtoSight Middle Ear Scope technology allows healthcare providers to actually see the contents of the middle ear, such as fluid, and this is the first step in diagnosing middle ear disease accurately. No proxies, no guessing. 

The OtoSight Middle Ear Scope has the potential to fundamentally transform the diagnosis and treatment of middle ear infection. It could improve the quality of care for one billion children worldwide, empower healthcare providers to make better decisions, and reduce costs exponentially. We are so excited to get this technology out to patients as soon as possible. Thanks, as always, for being part of our journey.

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PhotoniCare Takes First Place at the 2019 HealthTECH Startup Competition

PhotoniCare took home first place at the 7th Annual Insight Product Development 2019 HealthTECH Startup Competition. The annual competition, sponsored by Insight Innovation Center – Chicago, MATTER, and iBIO, brings together a mix of healthcare industry and community stakeholders. The program aims to achieve the following goals:

• Improve lives by bringing innovative health solutions to patients
• Encourage entrepreneurship in the healthcare industry
• Grow the medical innovation ecosystem
• Connect investors and corporations with early-stage companies

The competition included 10 finalists, selected based on a competitive application process, which came together on November 14th in Chicago, Illinois, to each give a five-minute startup live-pitch – PhotoniCare took first place! Tivic Health followed in second place, with Rhaeos in third, and CareBand took the People’s Choice Award. 

Ryan Nolan, PhotoniCare’s VP of Clinical Operations and Co-founder, gave the pitch and Mike Shaughnessy, PhotoniCare’s VP of Sales & Marketing, was also present to accept the $25,000 award.

“Participating in the HealthTech Startup Competition with such impressive competition was an amazing opportunity!”, commented Nolan. “On a night where so many innovative medical technologies were featured, I’m honored by the first place award. Thank you to all the sponsors for such a fun event. And thank you to all our partners for supporting our mission to provide superior ear infection diagnosis for the ~20 million annual U.S. patients suffering with this disease.”

Check out the full event recap as posted by the Insight Innovation Center here.

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The PhotoniCare team caps off a successful 2019 with a move to a new location

2019 has been a very exciting AND BUSY year for the PhotoniCare team. In particular, the year has brought more growth and movement forward for the staff than ever before. Between funding agreements, opportunities for research studies, multiple industry trade shows, and more, the team has been busier than ever.

If you’re just tuning in, here’s a snapshot of just a few of PhotoniCare’s 2019 highlights:

• Entered into an exclusive distribution agreement with Adachi Co., LTD, (Osaka, Japan) to commercialize the OtoSight Middle Ear Scope device throughout Japan. (read more here)
• Initiated a multi-site registered clinical study to evaluate the imaging capabilities and image analysis performance of the PhotoniCare OtoSight Middle Ear Scope with Children’s National Health System and Carle Foundation Hospital. (read more here)
• Received a Phase I SBIR award from the National Institutes of Health’s National Institute of Deafness & Communications Disorders. (read more here)
• Closed additional financing and brought on a new partner, Dreampact Ventures.

Over the past year it was becoming very clear that the team required more space to accommodate the growth of the company. So, if the year wasn’t busy enough, the team banded  together and made the move from the University of Illinois Research Park to a new office located on Fox Drive in Champaign, Illinois. PhotoniCare had occupied a space at Enterprise Works, a building within the Research Park, for over four years. First just one office, then an office and a lab, then an additional two offices. 

“The move to the new office space on Fox Drive has been exciting, to say the least,” commented Ryan Shelton, PhotoniCare’s CEO and co-founder. “Part of the move includes a build out of a portion of the office space. So the #EnginEarGuys got to try our hand at interior design! Much of the design, however, was spearheaded by one of PhotoniCare’s engineers, Heather Howard. She helped the team navigate the moving process and make decisions on everything from our new manufacturing layout to the aesthetics – carpet, paint, and furniture!”. 

The Fox Development Corporation recently featured the PhotoniCare team in their tenant newsletter, interviewing PhotoniCare CEO and Co-Founder Ryan Shelton. You can check out that highlight here.

Over the next few months the team, alongside Fox Development Corporation, will continue to build out our space and make the appropriate modifications to support both staff and manufacturing capabilities. We’re looking forward to welcoming the community into our space at an official unveiling set for early 2020. Stay tuned for details!

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The Team Behind the Technology

PhotoniCare was founded in 2013 out of a shared passion to make a real impact on the health of children. The people that make up PhotoniCare are dedicated, collaborative, and caffeinated, to say the least. Small but mighty, this team has done a lot in a short amount of time, which recently included an FDA clearance on their novel medical device, the OtoSight Middle Ear Scope. 

So who are the people behind the technology? Let’s meet Ryan Shelton, Ryan Nolan, Wei Kang, Heather Howard, and Nate Wetter:

RYAN SHELTON, CEO, CO-FOUNDER
What is your role with PhotoniCare:
I founded PhotoniCare with Ryan Nolan and Steve Boppart and have been serving as its CEO since. My role with the company is to cast vision, recruit people better than myself, and make sure we don’t run out of money. Those are my three main tasks. That said, I also sweep floors, flip burgers, and take out the trash. The variety keeps me interested.

What is your background?
I am a PhD-trained engineer, but have had to sacrifice much of that lab-work to learn how to effectively run a business. I like both sides of it, but I have come to love what I do as CEO. Like many entrepreneurs, I was completely unqualified to be CEO, having come straight from an academic post-doc. I like to think I’m more qualified now. One of my favorite jobs was a guitar tech at Daddio’s Music in Stillwater, OK. I still love music and play guitar often.

What is the most exciting part for you in developing this technology?
We made a pretty significant product pivot a couple of years ago and it carried a fair bit of risk, but resulted in our current product, which I am super pleased with. Making a bet like that and then seeing users at tradeshows praise it so enthusiastically is a great feeling.

What impact do you think OtoSight Middle Ear Scope will have on the healthcare community?
I think we’ll start by becoming the gold standard for ear infections, where better decisions early in the disease can drastically impact the downstream treatment and patient outcomes. After that, I’m super excited about some of the other disease indications in our pipeline.

What do you think is the best part about working on the PhotoniCare team?
I love working with people that love what they do. It is culture-defining, and our team loves what they do. It’s easy to get up in the morning when your goal for the day is to move something forward that will change the lives of millions of kids.

RYAN NOLAN, VP of CLINICAL OPERATIONS, CO-FOUNDER
What is your role with PhotoniCare:
I’m the VP of Clinical Operations & Co-founder, so I manage all of our clinical trials and publications with our amazing collaborators, as well as lead our reimbursement strategy.

What is your background?
I’m a clinical research professional and bioengineer from Pitt and Cornell, with 8+ years experience leading clinical trials in multiple areas of medicine. In other words, I love taking cool, new technology out of the research lab and developing it for clinical adoption. As one of the founders of PhotoniCare, I started out as a research scientist alongside Ryan Shelton in Professor Stephen Boppart’s lab at UIUC. We co-founded PhotoniCare to bring the promising and exciting technology we developed in the lab to the real world to improve the standard of care at the front lines of medicine, starting by addressing ear infections.

What is the most exciting part for you in developing this technology?
Seeing the devices we built together used to image patients in our collaborating hospitals. We put a lot of time and effort into designing and building these devices and it’s always satisfying to see the OtoSight Middle Ear Scope in action, as well as the reactions of not only the clinicians who use OtoSight Middle Ear Scope, but also the patients and their parents as they see inside their/their child’s ear for the first time. 

What impact do you think OtoSight Middle Ear Scope will have on the healthcare community?
I think the biggest impact will be how the OtoSight Middle Ear Scope drastically improves the way ears are examined at the front lines of medicine. Current tools, like the simple otoscope, are outdated and innovation is sorely needed to improve the care delivered.

What do you think is the best part about working on the PhotoniCare team?
I truly enjoy working as part of an agile, small team and the ability to wear multiple hats, so to speak. We face a diverse set of challenges as a medical device startup, and I appreciate the opportunity to work alongside and learn so much from all my colleagues as we work so hard together to bring OtoSight Middle Ear Scope to the world!

WEI KANG, DIRECTOR OF RESEARCH AND DEVELOPMENT
What is your role with PhotoniCare and what is your background:
I’m the Director of Research and Development at PhotoniCare. My background includes a Biomedical Ph.D. and five years at St. Jude Medical (now Abbott) where I had the opportunity to gain extensive knowledge of the integration of medical device companies. That knowledge included research and development, regulatory, quality, manufacturing, marketing, service, and more. 

What is the most exciting part for you in developing this technology?
It’s been exciting for me to be a part of the PhotoniCare team developing this technology because the TOMi Scope OtoSight Middle Ear Scope will be a tremendously helpful product to our customers – and will fulfill an unmet need. 

What impact do you think OtoSight Middle Ear Scope will have on the healthcare community?
OtoSight Middle Ear Scope will ultimately reduce medical costs to our society, and set an example of how low cost optical coherence tomography (OCT) can find a market. 

What do you think is the best part about working on the PhotoniCare team?
At PhotoniCare, we approach OCT differently than the mainstream OCT companies. I like that I can spend time learning – and discover new opportunities where we can implement our technology.

HEATHER HOWARD, DIRECTOR OF MANUFACTURING
What is your role with PhotoniCare:
I’m the director of manufacturing, so I manage the whole process of building the device and making sure it passes our quality standards. I’ve also been heavily involved in testing the device and preparing our submission to the FDA.

What is your background / work history:
I studied mechanical engineering and worked in medical devices design in Boston before moving out to Champaign and joining PhotoniCare.

What has been the most exciting part for you in developing this technology:
When I tell people about what I’m working on here at PhotoniCare, everyone has their own story about how ear infections have impacted them. Parents of young children are the most enthusiastic, but this really is a problem that touches a lot of people. I love getting to work on a device that can help. I also enjoy the opportunity to get involved with many aspects of the project and learn new things along the way.

What impact do you think this technology will make:
I think the biggest impact will be to give doctors and patients (and patients’ parents) more confidence in their treatment choices by providing a clear image of whether there’s fluid in the ear or not.  

What is your favorite part about working on the PhotoniCare team:
I love working with a group of people who are so dedicated to this project, but are still able to be flexible and have fun together. Team cookouts are also a highlight!

NATE WETTER, BIOMEDICAL ENGINEER
What is your role with PhotoniCare and what is your background:
I’m an Engineer with PhotoniCare. My background includes degrees in Computer Engineering and Biomedical Engineering from the University of Illinois, and a Medical Doctorate from Southern Illinois University. I also have experience with developing novel medical training technology.

What has been the most exciting part for you in developing this technology:
I like that at PhotoniCare I can draw on every part of my varied background experiences to support the team’s efforts in developing our technology.

What impact do you think this technology will make:
We will finally be good at dealing with an affliction that, despite affecting almost everyone, we have not been good at dealing with before now.

What is your favorite part about working on the PhotoniCare team?
More or less – we are all new to this. So I really enjoy that we are all learning together and working together.

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Is it dangerous to swim with an ear infection?

Summer is here, temperatures are rising, and kids want to get outside and cool off. It can be crushing for your little ones if they have to miss out on the chance to go swimming because of an ear infection. But do they have to stay out of the water? In this month’s blog, we explore the differences between swimmer’s ear and a middle ear infection and discuss whether it is safe to go back into the water.

Swimmer’s Ear
Also known as otitis externa, swimmer’s ear is an infection of the outer ear, commonly caused by excess moisture remaining in the ear, which enables bacteria to grow. The bacteria that causes this type of infection can also grow in scratches to the ear canal lining (such as an abrasion caused by inserting something into the ear, like a cotton swab).

Symptoms range from itching in the ear canal, discharge, and mild discomfort that can be felt when the outer ear is touched, to muffled hearing in more moderate cases or even severe pain, blockage of the ear canal, and fever in advanced cases. Typically, swimmer’s ear is treated first with a thorough cleaning. The Mayo Clinic notes that “cleaning your outer ear canal is necessary to help ear drops flow to all infected areas. Your doctor will use a suction device or ear curette to clean away discharge, clumps of earwax, flaky skin and other debris.” Then, ear drops are used to clear up the infection, plus over-the-counter pain relievers, as needed.

In order to prevent swimmer’s ear, healthcare providers recommend keeping as much moisture out of the ear canal as possible. Dry your children’s ears thoroughly after bathing and swimming by wiping the outer ear gently with a soft washcloth. We’ve all probably detected that sloshy feeling in the ears after (or during) a swim. You can help drain water from the ear canal by tipping your head to the side to let it run out. You can also use a blow dryer on its lowest setting – but be sure to hold it at least a foot away from the ear. For those who swim regularly, it is also recommended to wear a tight-fitting swim cap that covers the ears, to keep as much water out as possible.

Swimmer’s ear is easily treatable and should be addressed quickly when symptoms emerge. If left untreated, complications include temporary hearing loss or more chronic, widespread infection. Because swimming is the most prominent risk factor – especially swimming in water prone to high bacteria levels – anyone diagnosed with swimmer’s ear should stay out of the water until the infection clears up. This means no swimming or scuba diving, and even protecting your ear from water in the bath or shower is recommended.

Middle Ear Infection
One of the most common health problems children will face in their lifetime, middle ear infection (acute otitis media or AOM) affects the ear further down the canal, behind the eardrum. At PhotoniCare, our focus is on visualization of the middle ear space. AOM is an ear infection where the middle ear (area behind the eardrum) becomes inflamed and infected. The eustachian tube that runs from the middle of the ear to the back of the throat becomes swollen, trapping infected fluid in the middle ear. This occurs due to a variety of reasons including the flu and common cold. Because the eustachian tube is much shorter and more horizontal in children, it can become blocked much easier than in adults, and is more susceptible to middle ear infection. In contrast to swimmer’s ear, however, water in the ear canal does not cause middle ear infections.

Symptoms of a middle ear infection usually appear rapidly, and include fever, fluid draining from the ear, headache, and even loss of appetite. Behaviors that indicate your child might have an ear infection include tugging at the ear, out-of-the-ordinary crying or fussiness, trouble sleeping, or not reacting to sounds.

While most middle ear infections clear up on their own, it is important to contact your pediatrician if symptoms persist more than 24 hours, to monitor progression and determine if antibiotics are needed.

The good news for parents and kids eager to get to the pool is that even with a middle ear infection, swimming is not out of the question. You do still want to dry the ears thoroughly to avoid the risk of an additional infection on top of otitis media, but water from the pool will not typically exacerbate an infection in the middle ear.

Recap:
Swimmer’s ear and middle ear infections are two different beasts. The CDC notes that an easy way to tell them apart is the presence of pain in the outer ear: “If you can wiggle the outer ear without pain or discomfort then your ear condition is probably not swimmer’s ear.”

Once diagnosed, can we go swimming?

• with swimmer’s ear = NO (not until the infection clears)
• with a middle ear infection = YES

So give that ear a tug, and if it wiggles without pain, you can enjoy a refreshing dip in the pool!

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How dangerous are untreated ear infections in adults?

Itchiness or pain. Trouble hearing. Fluid leaking out of the ears. These symptoms may have been all too common when we were kids, but as an adult, the signs of an ear infection are probably something you have not felt in quite some time. While ear infections—middle ear infections in particular—are more common in children, they are not unheard of in adults. In this blog post we explore the risks and complications of leaving an ear infection untreated in adults.

In our last blog, we talked about the difference between middle ear infections (otitis media), and outer ear infections (otitis externa), more commonly known as swimmer’s ear. Otitis media is caused by either bacteria or viruses. A common cold, the flu, or allergy symptoms that cause congestion and swelling of the nasal passages, throat, and eustachian tubes can sometimes lead to an infection. Anything that makes the nose stuffy has a tendency to cause swelling and blockage of the eustachian tubes. Swelling from colds or allergies can keep the eustachian tubes from opening and this leads to pressure changes and the accumulation of fluid in the middle ear. This pressure and fluid will cause pain and sometimes persistent fluid can lead to an infection.

Swimmer’s ear, on the other hand, is an outer ear infection, typically caused by bacteria growing due to the presence of excess moisture in the ear or an abrasion to the lining of the ear canal. This type of infection is much more common in adults, whether they regularly hit the pool or not. The excess moisture that causes otitis externa can also come from baths and showers, or the infection can grow out of an aggressive cotton swab or even irritation from beauty products or jewelry.

Potential Complications

The Mayo Clinic notes that although the majority of ear infections do not cause lasting problems, recurring infections left untreated can lead to serious complications. Due to swelling and/or fluid buildup, ear infections often cause mild hearing loss, however it usually clears up along with the infection. Extensive fluid in the middle ear due to chronic ear infections, however, can lead to more severe damage to the eardrum, resulting in a more permanent hearing impairment.

Untreated chronic ear infections can also cause tears in the eardrum. These tears will typically heal within a few days, though in more extreme cases, surgical repair might be required.

The other primary risk of leaving an ear infection untreated is that the infection could spread beyond the ear. An untreated infection can spread to other nearby tissue in and around the ear, and in rare cases even into the skull, resulting in meningitis. Infections will more commonly spread to the mastoid, just behind the ear, which can damage the bone and form pus-filled cysts.

These complications highlight the critical need to monitor symptoms in the case of an ear infection and to seek treatment if they continue or even worsen after a day or two. While you may not need treatment right away, it is important to consult with your physician to know what to look out for and when to seek further testing in order to avoid more extensive damage. Initial diagnosis usually involves an examination, but lab testing may be needed if the infection does not clear up.

Ear Infection Treatments

The good news is, most ear infections clear up on their own, and when treatment is needed, it is usually relatively minor. Swimmer’s ear is typically treated with a thorough cleaning, ear drops, and over-the-counter pain medication as needed. A middle ear infection will more often than not be treated first by monitoring symptoms and possibly adding anesthetic drops if there are no signs of a tear in the eardrum. While antibiotics can also be used to treat middle ear infections, they are generally reserved for more extreme cases, so as not to build up unnecessary antibiotic resistance.

Ear Infection Prevention

The best ways to prevent ear infections involve the steps we take as adults to prevent the common cold and boost our immune systems. Wash your hands frequently, don’t sneeze or cough out into the air, and be careful when interacting with those who show symptoms of a virus (something we have become even more keenly aware of in the age of COVID-19). Avoid smoking and secondhand smoke and eat plenty of fruits and vegetables to keep your resistance up.

When it comes to an outer ear infection, make sure you dry your ears thoroughly after a bath, shower, or swim. Be extremely careful with cotton swabs and avoid strong movements that could scratch your ear canal.

And above all, pay attention to how you feel. If you notice out-of-the ordinary pain or itches, keep an eye on your symptoms and consult with your doctor so that you don’t risk letting a little ear infection get out of control. The risk of an infection may be low as an adult, but the consequences are not if left untreated.

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The #EnginEarGuys Look Back at 2018’s Most Memorable Moments

The last few years have been kind to us at PhotoniCare, but no year has given us the ability to grow more than 2018 did. Here is a recap of some of our most memorable moments from this past year:

• We won first place in the 2018 SPIE Startup Challenge. We started the year with a win at the 2018 SPIE Startup Challenge in San Francisco, CA. The SPIE Startup Challenge is held annually at Photonics West, the world’s most comprehensive technical conference and exhibition spanning biophotonics for brain research and healthcare, lasers for research and advanced manufacturing, sensors and camera systems, imagining and displays, communications and optoelectronics, plus the core optical components that enable many of today’s consumer products. PhotoniCare competed in the Biophotonics and point of care track, consisting of 10 startups from across the world. Ryan Shelton, co-founder and CEO, pitched at the presentation. As winner of the best pitch, PhotoniCare was awarded with a $10,000 cash prize in addition to a week-long entrepreneur bootcamp training, numerous promotion opportunities, and reimbursement for travel expenses.
• We competed in the HealthSpark 2018 Barracuda Bowl. Our year of achievements started out with a bang at the Barracuda Bowl in Texas. Presented by HealthSpark, the Barracuda Bowl was part of the South by Southwest Conference and consisted of fifteen of the most promising startups in healthtech. We had the privilege of being one of those coveted fifteen spots and had the opportunity to really showcase our company and product. We certainly attracted plenty of notice and took home the “Company of Choice” award by the TMC Innovation Institute.
• We received honors at the Angel Capital Association in Boston. About a month later, we were recognized as part of the Luis Villalobos Award by the Angel Capital Association. Villalobos, was known for his appreciation of ingenuity and was always looking for cutting edge companies to invest in. After his passing, the Luis Villalobos Awards honored his namesake by recognizing the most ingenious and innovative ideas. This year, we were selected as one of the four finalists across the country. It was an incredible honor and was proof of the hard work that our whole team had put in to our technology and our company. Thank you to VisionTech Partners for the humbling nomination!
• We received a clinical research grant from the National Institutes of Health. In May, we received some exciting news! The National Institutes of Health awarded us a $2.1M award through the Phase II-b Small Business Innovation Research (SBIR) program. With this additional funding from the National Institute of Deafness and Communication Disorders, we hope to continue to build and expand on our clinical trials to advance the TOMi Scope [OtoSight Middle Ear Scope] even further.
• We were selected by MedTech Innovator for 2018 Showcase and Accelerator. 2018 continued to get better for us as we were chosen as a Top 50 startup company by MedTech Innovator from over 700 applicants. We participated in a four-month program that paired us with representatives from MedTech Innovator’s corporate partners, the National Institutes of Health (NIH), the U.S. Food and Drug Administration (FDA), and the U.S. Military. We concluded the program at the MedTech Conference in Philadelphia.
• We had an incredibly successful MedTech Conference. Continuing our trend of having a strong 2018, we were the recipients of two awards that recognize promising new startups. The first of these was the Execution Award –  presented jointly by AdvaMed Accel and MedTech Innovator, this award recognized strong leadership teams with next-generation innovations. The second, The Virginia Shimer Rybski Memorial Award, was created to encourage the enthusiastic pursuit of business excellence in the medical technology industry. This award, presented each year during the association’s annual meeting to a single company, was created and named after the former President and CEO of Regenesis Biomedical. The winning company each year receives a sizable grant, a cash prize to be applied toward expenses required to commercialize the product and a one-year membership with AdvaMed.
• PhotoniCare exhibits at AAO and AAP.
  Four members of the PhotoniCare team took to the exhibition halls this fall as they attended and exhibited at the American Academy of Otolaryngology – Head and Neck Surgery Annual Meeting and OTO Experience in Atlanta, Georgia and at the American Academy of Pediatrics Experience National Conference & Exhibition in Orlando, Florida. The team demonstrated the TOMi Scope [OtoSight Middle Ear Scope] to clinicians from around the world, made some great contacts, and look forward to participating in these valuable events again in 2019.

Yes, a pretty special year for us, and if 2018 is any indication of our future success, we can’t wait to dig into 2019 and beyond! 

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