{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T19:27:03Z","timestamp":1764962823853,"version":"3.46.0"},"reference-count":27,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2021-06438"],"award-info":[{"award-number":["2021-06438"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Centrala ALF","award":["RV-979824","RV-939033"],"award-info":[{"award-number":["RV-979824","RV-939033"]}]},{"DOI":"10.13039\/501100001858","name":"VINNOVA","doi-asserted-by":"publisher","award":["2021-01721"],"award-info":[{"award-number":["2021-01721"]}],"id":[{"id":"10.13039\/501100001858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Otitis Media (OM) is a prevalent condition in children that can lead to hearing impairment and significant healthcare costs. Inaccuracy in primary care and equipment cost in developing countries are concerning issues in OM diagnostics. Acoustic Reflectometry (AR) offers a low-cost, non-invasive diagnostic alternative, though it has fallen short on accuracy in previous studies. The primary aim of this study was to establish a computational simulation and an experimental model able to reproduce AR performed on human individuals to enable further research and accuracy improvement. The secondary aim was to perform a sensitivity analysis on AR instrument user error. Simulations and experiments were validated against measurements from human individuals with OM and normal ears, respectively. The results reveal that the simulation sufficiently reproduces human AR measurements and distinguishes an ear with OM from a healthy ear. The experiment delivered satisfying measurements on OM but underperformed in a normal ear scenario. The simulations and experiments overpredicted sound reflection in OM. The sensitivity study showed promising robustness of AR, concluding that computational simulation is a viable tool and complement to an experimental approach in research of AR. Future efforts should focus on paediatric models and partially filled middle ear simulations to promote clinical relevance.<\/jats:p>","DOI":"10.3390\/s25247420","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T18:42:02Z","timestamp":1764960122000},"page":"7420","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computational Simulation and Experimental Validation of Acoustic Reflectometry in Otitis Media"],"prefix":"10.3390","volume":"25","author":[{"given":"Karl","family":"Nyberg","sequence":"first","affiliation":[{"name":"Departament of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6445-0550","authenticated-orcid":false,"given":"Manfred","family":"Lindmark","sequence":"additional","affiliation":[{"name":"Departament of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-565X","authenticated-orcid":false,"given":"Mimmi","family":"Werner","sequence":"additional","affiliation":[{"name":"Departament of Clinical Sciences, Otorhinolaryngology, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1141-5143","authenticated-orcid":false,"given":"Petter","family":"Holmlund","sequence":"additional","affiliation":[{"name":"Departament of Applied Physics and Electronics, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1478-4945","authenticated-orcid":false,"given":"Thorbj\u00f6rn","family":"Lundberg","sequence":"additional","affiliation":[{"name":"Departament of Public Health and Clinical Medicine, Family Medicine, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3363-7414","authenticated-orcid":false,"given":"Fredrik","family":"\u00d6hberg","sequence":"additional","affiliation":[{"name":"Departament of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Ume\u00e5 University, 90187 Ume\u00e5, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Monasta, L., Ronfani, L., Marchetti, F., Montico, M., Brumatti, L.V., Bavcar, A., Grasso, D., Barbiero, C., and Tamburlini, G. (2012). Burden of Disease Caused by Otitis Media: Systematic Review and Global Estimates. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0036226"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e552","DOI":"10.1055\/s-0043-1767802","article-title":"Economic Burden of Otitis Media Globally and an Overview of the Current Scenario to Alleviate the Disease Burden: A Systematic Review","volume":"28","author":"Bhatia","year":"2024","journal-title":"Int. Arch. Otorhinolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1093\/fampra\/cmg505","article-title":"Is it possible to diagnose acute otitis media accurately in primary health care?","volume":"20","author":"Blomgren","year":"2003","journal-title":"Fam. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s11908-015-0476-7","article-title":"Acute Otitis Media in Children\u2014Current Treatment and Prevention","volume":"17","year":"2015","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Sundvall, P.-D., Papachristodoulou, C.E., and Nordeman, L. (2019). Diagnostic methods for acute otitis media in 1 to 12 year old children: A cross sectional study in primary health care. BMC Fam. Pract., 20.","DOI":"10.1186\/s12875-019-1018-4"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.otorri.2022.07.002","article-title":"Value of simple otoscopy in diagnosing otitis media with effusion in children","volume":"74","author":"Azevedo","year":"2022","journal-title":"Acta Otorrinolaringol. Engl. Ed."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1046\/j.1365-2273.1997.00023.x","article-title":"The predictive value of tympanometry in the diagnosis of middle ear effusion","volume":"22","author":"Watters","year":"1997","journal-title":"Clin. Otolaryngol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1097\/AUD.0000000000001037","article-title":"Improving the Differential Diagnosis of Otitis Media With Effusion Using Wideband Acoustic Immittance","volume":"42","author":"Merchant","year":"2021","journal-title":"Ear Hear."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ijporl.2013.09.029","article-title":"Applicability of spectral gradient acoustic reflectometry (EarCheck): Screening patients who need surgical treatment for chronic otitis media with effusion","volume":"78","author":"Lee","year":"2014","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_10","first-page":"477","article-title":"Spectral gradient acoustic reflectometry in the diagnosis of middle-ear fluid in children","volume":"264","author":"Teppo","year":"2006","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1016\/j.ijporl.2013.08.019","article-title":"Consumer acoustic reflectometry: Accuracy in diagnosis of otitis media with effusion in children","volume":"77","author":"Muderris","year":"2013","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1177\/014556130408300911","article-title":"Modern Acoustic Reflectometry: Accuracy in Diagnosing Otitis Media with Effusion","volume":"83","author":"Babb","year":"2004","journal-title":"Ear, Nose Throat J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1001\/archpedi.161.9.884","article-title":"Spectral Gradient Acoustic Reflectometry Compared with Tympanometry in Diagnosing Middle Ear Effusion in Children Aged 6 to 24 Months","volume":"161","author":"Chianese","year":"2007","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1016\/j.ijporl.2015.06.040","article-title":"Parental Role in the Diagnostics of Otitis Media: Can Layman Parents Use Spectral Gradient Acoustic Reflectometry Reliably?","volume":"79","author":"Laine","year":"2015","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/02813430903072165","article-title":"Consumer acoustic reflectometry by parents in detecting middle-ear fluid among children undergoing tympanostomy","volume":"27","author":"Teppo","year":"2009","journal-title":"Scand. J. Prim. Heal. Care"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Chan, J., Raju, S., Nandakumar, R., Bly, R., and Gollakota, S. (2019). Detecting middle ear fluid using smartphones. Sci. Transl. Med., 11.","DOI":"10.1126\/scitranslmed.aav1102"},{"key":"ref_17","unstructured":"Nielsen, L.B. (2023). Simulation and Physical Testing Using Standardized Ear Simulators. DAGA Hambg."},{"key":"ref_18","unstructured":"Nielsen, L.B. (2022). The Digital Twin of a New and Standardized Fullband Ear Simulator. DAGA Hambg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3527","DOI":"10.1121\/1.2793699","article-title":"Multifield coupled finite element analysis for sound transmission in otitis media with effusion","volume":"122","author":"Gan","year":"2007","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1080\/10255842.2017.1316382","article-title":"The human otitis media with effusion: A numerical-based study","volume":"20","author":"Areias","year":"2017","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1186\/s40064-016-3060-1","article-title":"Modeling and experimental verification of a new muffler based on the theory of quarter-wavelength tube and the Helmholtz muffler","volume":"5","author":"Wu","year":"2016","journal-title":"SpringerPlus"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.jcp.2018.06.005","article-title":"Acoustic boundary layers as boundary conditions","volume":"371","author":"Berggren","year":"2018","journal-title":"J. Comput. Phys."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1121\/1.5024360","article-title":"The area discontinuity between probe and ear canal as a source of power-reflectance measurement-location variability","volume":"143","author":"Lewis","year":"2018","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_24","unstructured":"COMSOL AB (2021). Artificial Ears, 2021, COMSOL Multiphysics Application Library. [COMSOL Multiphysics model]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"139","DOI":"10.3342\/ceo.2008.1.3.139","article-title":"Tympanometry and CT Measurement of Middle Ear Volumes in Patients with Unilateral Chronic Otitis Media","volume":"1","author":"Ahn","year":"2008","journal-title":"Clin. Exp. Otorhinolaryngol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1121\/10.0005822","article-title":"The influence of otitis media with effusion on middle-ear impedance estimated from wideband acoustic immittance measurements","volume":"150","author":"Merchant","year":"2021","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/AUD.0b013e318174f07c","article-title":"Sources of Variability in Reflectance Measurements on Normal Cadaver Ears","volume":"29","author":"Voss","year":"2008","journal-title":"Ear Hear."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/24\/7420\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T18:58:08Z","timestamp":1764961088000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/24\/7420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":27,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["s25247420"],"URL":"https:\/\/doi.org\/10.3390\/s25247420","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]}}}