A novel handheld device for the treatment of a common ear complaint that could significantly improve current surgical methods has been developed by the researchers from the National University of Singapore (NUS).

The device, known as CLiKX, is the first of its kind and researchers claim it is extremely time and cost effective – by cutting hours off the traditional method and reduce two-thirds of the cost.

The interdisciplinary project is headed by Associate Professor Tan Kok Kiong from the Department of Electrical and Computer Engineering, and Adjunct Associate Professor Lynne Lim from NUS Yong Loo Lin School of Medicine's Department of Otolaryngology. It involved five researchers from the engineering and medical facilities of the NUS.

90% of individuals suffering from OME are children

The condition, known as Otitis Media with Effusion (OME), also known as "glue ear", is a common condition that affects up to 709 million people worldwide annually. In Singapore, nine out of 10 affected individuals are children and about 84,000 children suffer from it annually.

This is a breakthrough, as OME can lead to hearing impairment, tumours, brain infections and delays in speech and language learning if left untreated.

Traditionally, it is treated with antibiotics but sometimes it is ineffective.

"For patients with three or more episodes of OME within a year – especially if there is hearing loss and speech difficulties, some with craniofacial predispositions or those who are concerned about building resistance to long-term use of antibiotics, grommet tube placement surgery is currently the gold standard of care," explained Dr Lim.

The grommet is a very small tube that is inserted into the patient's ear drum during surgery to help drain the fluid in the middle ear, which can take about 30 minutes to complete.

CLiKX to significantly save on cost, manpower and resources

CLiKX saves time by making a microincision in the patient's eardrum to insert a tube that drains the fluid. The procedure takes seconds compared to surgery which includes the risk of the patient – especially in young children where a negative impact on brain development is known – being under general anaesthesia.

The procedure also saves manpower as it can be done in a ward or clinic – requiring only two to three medical professionals, as compared to surgery, which needs up to 10, the researchers remarked.

"We expect costs, manpower, and resources to be lowered substantially; and this in turn, would be welcomed by patients, healthcare institutions, and insurers," added Associate Professor Tan.

The device – weighing at only 185g – is sensor-guided and battery-operated. It also works with a range of commercially available grommets. It is now entering the trial phase after 6 years of research.

Underdeveloped countries can benefit from CLiKX

Inspiration for the device came to Professor Lim when she was on a humanitarian trip to Vietnam eight years ago.

"I was removing a large tumour from a young child and we were successful. But, because they did not have general anaesthetic, we could not solve his OME problem," she explained.

"CLiKX can make a significant impact by making grommet placement surgeries more accessible to these patients most in need, and it simplifies the procedure for doctors and patients," she added.

OME affects mostly children as their inner ears are relatively undeveloped, making it difficult for fluid to drain normally from the middle ear.

The team hopes to carry out its first-in-man trial in 2018 and commercialise the device with hopes to launch the product globally by 2020. MIMS

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