Page ContentOverviewResearch in this laboratory is concerned with understanding how sounds travel from the outer, through the middle, and to the inner ear in people with normal hearing and in people with various hearing disorders. Our goal is to use this information to improve the assessment of hearing loss, particularly our ability to differentiate the cause of a hearing loss.The lab has a particular emphasis on conductive hearing loss. Specifically, we are interested in: understanding how different causes of conductive hearing loss impact the auditory systemdeveloping objective and non-invasive methods to diagnose and differentiate these causes, and determining how transient and fluctuating conductive hearing loss impacts long-term auditory processing and speech and language development.Our work uses a combination of standard clinical measures and experimental measures (including otoscopy, pure-tone audiometry, tympanometry, wideband acoustic immittance, otoacoustic emissions, and electrophysiological responses including the auditory brainstem response) and compares these assessments to characteristics of various pathologies.Current StudiesDifferential Diagnosis of Otitis MediaOur current work is focused on improving the differential diagnosis of ear infections and middle-ear fluid (otitis media). Otitis media is one of the most common childhood diseases, but there is little consensus with respect to treatment options, which include watch-and-wait approaches, antibiotic use, and surgical placement of pressure equalization (PE) tubes. Currently, there is no evidence-based method to determine which treatment option is most appropriate for a given patient. The goal of this project is to develop methods to differentiate variations in otitis media in order to guide treatment decisions. Differentiating cases of otitis media that require treatment from those that do not would represent a substantial advance in terms of public health. Our findings have the potential to influence the understanding and therapeutic management of childhood hearing loss related to otitis media.FacilitiesOur laboratory space is approximately 600 square feet and includes a spacious sound suite equipped with everything necessary to perform both pediatric and adult behavioral hearing assessments. This includes a Otometrics Masden Astera 2-Channel Clinical Audiometer, mounted speakers for sound field testing, a video visual-reinforcement audiometry system, a video otoscope, and age-appropriate toys for testing infants and preschoolers. The laboratory is also equipped with an Interacoustics Titan Impedance Probe for assessment of wideband acoustic immittance, tympanometry, and otoacoustic emissions as well as a Vivosonic Integrity V500 G2 auditory diagnostic system for assessment of auditory evoked potentials. Outside of the booth, is a large table and chairs where subjects and their families can be consented, storage space for laboratory equipment and files, and multiple workstations for personnel. Additional equipment housed in the laboratory include the tools needed to quantify middle-ear fluid characteristics including a RheoSense microVISC viscometer and agar plates necessary for bacterial assays.Lab StaffGabrielle R. Merchant, Au.D., Ph.D. Director Gabrielle Merchant is a hearing scientist and audiologist with interdisciplinary training in audiology, engineering, psychoacoustics, biology, and auditory neuroscience. She completed her undergraduate degree at Smith College, where she self-designed an interdisciplinary major in Speech and Hearing Science. There, she had an opportunity to work with both Dr. Susan Voss and Dr. Jill de Villiers. She then went on to the Harvard-MIT Division of Health Sciences and Technology Speech and Hearing Bioscience and Technology Program, working with Dr. Heidi Nakajima and Dr. John Rosowski, earning her PhD in 2014. Gabrielle always had a strong desire to combine clinical work with research, so upon graduation from SHBT in 2014, she entered the clinical doctoral training program in Audiology at the University of Massachusetts Amherst, where she spent three years training as an audiologist and working in the laboratories of Dr. Karen Helfer and Dr. Richard Freyman. Gabrielle came to Boys Town National Research Hospital in 2018, first completing her fourth-year clinical externship, and then transitioning to her role as the Director of the TAPP Lab.Sarah Al-Salim, Au.D. Research Audiologist Sarah Al-Salim is a Research Audiologist in the Translational Auditory Physiology and Perception Lab and in the Clinical Measurement Program at Boys Town National Research Hospital (BTNRH). She completed her Au.D. at the University of Nebraska-Lincoln, during which time she worked in the Human Sensory Physiology Lab at BTNRH with Drs. Michael Gorga and Steve Neely. She completed her clinical externship in audiology in Chicago, Illinois and spent 4 years working with adults and children with hearing loss in a multidisciplinary clinic prior to returning to Omaha and BTNRH. Currently, her primary research interest lies in the development of communication in children with hearing loss. Of particular interest are clinical assessment tools and intervention strategies used to promote language development leading to improved academic and social outcomes in this population.Richard Tempero, M.D., Ph.D.Richard Tempero is a physician-scientist at Boys Town National Research Hospital and formerly directed the Lymphatic Research Laboratory. He completed his undergraduate degree at the University of Wisconsin Madison and his M.D. and Ph.D. at the University of Nebraska Medical Center. Dr. Tempero closely collaborates on our project on the Differential Diagnosis of Otitis Media, providing expertise on the otologic care and treatment of otitis media and the collection and analysis of middle-ear fluid samples.