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Our Research

Clinical Professor Harvey Coates of the University Department of Otolaryngology Head and Neck Surgery and the School of Paediatrics and Child Health at the University of Western Australia has been involved in basic, translational and clinical research for over 30 years. As a Fellow in the Department of Otorhinolaryngology at the Mayo Clinic in Rochester Minnesota USA he was awarded a national resident research prize in 1977 for his research into the immunology and role of Epstein-Barr virus in naso-pharygeal cancer and in the unknown primary in the head and neck. More recently his research has been principally in the field of otitis media particularly in Aboriginal children’s ear disease. He has published most recently with colleagues on many aspects of Indigenous ear health including editing a supplement of the Medical Journal of Australia on otitis media in 2010. He has been involved in research with the Telethon Institute for Child Health Research and Princess Margaret Hospital for Children and has been awarded with his co-researchers and collaborators a number of major research awards including a $4.3 million research grant from the National Institute of Health (USA) for research on biofilm with colleagues in Pittsburgh, an NH & MRC $1.05 million grant on the genetics of otitis media with Dr Jennie Blackwell and colleagues, a $286 000 grant for research on bacterial biofilm as well as a $206 000 grant for implementing the first major pilot study into universal newborn hearing screening in Australia both from The Garnett Passe and Rodney Williams Memorial Foundation. In addition to Indigenous research on the genetics of recurrent otitis media and the immunology of otitis media in Indigenous children he has also been involved in the swimming pool project in Burringurrah, the Kalgoorlie project, the Ear Bus Project in Midvale, and a myringoplasty study.

The most important recent papers and research are included in the following section

Recent Papers

1. Coates H. Chronic Suppurative Otitis Media without Cholesteatoma. In Alpers C, Bluestone M, et al (eds) Advanced Therapy of Otitis Media. London BC Decker Inc 2004:299-305.

This chapter which included our discovery of the first ever demonstrated bacterial biofilm in chronic suppurative otitis media or for that matter in middle ear disease in humans has been invaluable to us and our collaborators in obtaining a and major NIH and GPRWMF grant on bacterial biofilm and its role in middle ear disease including otitis media, otitis media with effusion and chronic suppurative otitis media. Other researchers have discovered bacterial biofilm in the adenoid region as well.

2. Coates H, Thornton R, Langlands J, Filion P, Keil A, Vijayasekaran S, Richmond P. The role of chronic infection in children with otitis media with effusion: Evidence for intracellular persistence of bacteria. Otolaryngology-Head Neck Surgery 2008 138 (6):778-781.

This paper describes for the first time the presence of intracellular cocci in middle ear mucosa or tissue in recurrent acute otitis media and otitis media with effusion and its recalcitrance to management with regular antibiotic therapy. Our team has unpublished work in progress demonstrating intracellular bacteria in the adenoid stroma and in the tonsillar stroma and the concurrence of bacteria species within the adenoids and middle ear mucosa of children with recurrent acute otitis media.
3. Kadhim A, Spilsbury K, Semmens J, Coates H, Lannigan F. Adenoidectomy for middle ear effusion: a study of 50,000 children over 24 years. Laryngoscope. 2007 Mar;117(3):427-33.

The paper on adenoidectomy for middle ear effusion studying 50 000 children over 24 years indicates that adenoidectomy, together with insertion of ventilation tubes in children with middle ear effusion reduces the need for a second set of ventilation tubes by 50% in the largest such study published.

Our most important research and publications and why

1. The chapter on chronic suppurative otitis media as above for the reasons mentioned in the first section.

2. Coates H, Thornton R, Langlands J, Filion P, Keil A, Vijayasekaran S, Richmond P. The role of chronic infection in children with otitis media with effusion: Evidence for intracellular persistence of bacteria. Otolaryngology-Head Neck Surgery 2008 138 (6):778-781.

Intracellular cocci for the first documented description of intracellular bacteria within the mucosa of the middle ear in children with otitis media with effusion and recurrent acute otitis media.

3. Lehmann D, Tennant MT, Silva DT, McAullay D, Lannigan F, Coates H, Stanley FJ. Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study. 2003 BMJ.23;327(7412):415-9. Erratum in: BMJ. 2003 Sep 20;327(7416):663.

This study was published in the BMJ in 2003 and although over five years old it is a landmark study in translational research in Indigenous children’s ear disease.

4. Jacoby P, Coates H, Arumugaswamy A, et al. The effect of passive smoking on the risk of otitis media in Aboriginal and non-Aboriginal children in the Kalgoorlie-Boulder region of Western Australia. MJA 2008; 188 (10): 599-603.

5. Lehmann D, Weeks S, Jacoby P, Elsbury D, Finucane J, Stokes A, Monck R, Coates H, and The Kalgoorlie Otitis Media Research Project Team. Absent otoacoustic emissions predict otitis media in young Aboriginal children: A birth cohort study in Aboriginal and non-Aboriginal children in an arid zone of Western Australia. BMC Pediatrics 2008,8:32:

These longitudinal studies demonstrated the effects of passive smoking on the risk of otitis media in Aboriginal children in the desert region of Western Australia and the utilization of absent otoacoustic emissions as an alternate tympanometer in children under the age of 6 months and its relationship to otitis media.

6. Morris P, Richmond P, Lehmann D, Leach A, Gunasekera H. Coates H. New horizons: otitis media research in Australia. MJA Vol 191, No 9. S Nov 2009. S73-S77.
This paper with colleagues is a summary of previous research in Indigenous ear health, current research and future research possibilities.

Our practice believes that good clinical and basic science researches go hand in hand with good clinical care of our patients and that by being involved in research both children, parents and the community benefit.

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