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Morgenstern J, Kreusch T, Golde J, Steuer S, Ossmann S, Kirsten L, Walther J, Zahnert T, Koch E, Neudert M. In Vivo Thickness of the Healthy Tympanic Membrane Determined by Optical Coherence Tomography. Otol Neurotol 2024; 45:e256-e262. [PMID: 38361307 DOI: 10.1097/mao.0000000000004132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Tympanic membrane (TM) thickness is an important parameter for differentiation between a healthy and a pathologic TM. Furthermore, it is needed for modeling the middle ear function. Endoscopic optical coherence tomography (eOCT) provides the opportunity to measure the TM thickness of the entire TM in vivo. MATERIALS AND METHODS A total of 27 healthy ears were examined by eOCT. The system uses a light source with a central wavelength of 1,300 nm. The endoscope with an outer diameter of 3.5 mm provides a field of view of 10 mm and a working distance of 10 mm. Thickness measurements were carried out at 8 points on the TM. Additionally, the existing literature was analyzed, and a mean TM thickness value was determined. RESULTS The mean thickness of the TM over all measurement points of the pars tensa was 120.2 μm, and the pars flaccida was significantly thicker with a mean thickness of 177.9 μm. Beyond that, there were no significant differences between the single quadrants. The mean TM thickness in the literature was 88.8 μm. DISCUSSION EOCT provides the possibility for in vivo thickness determination of the TM. The mean thickness seems to be higher than in the previous studies, which were mostly carried out ex vivo. Our study takes the three-dimensional refraction into account and provides a method for the refraction correction.
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Affiliation(s)
- Joseph Morgenstern
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
| | - Theodor Kreusch
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
| | | | - Svea Steuer
- Department of Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
| | - Steffen Ossmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
| | | | - Julia Walther
- Department of Medical Physics and Biomedical Engineering, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
| | - Thomas Zahnert
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
| | - Edmund Koch
- Department of Anesthesiology and Intensive Care Medicine, Clinical Sensoring and Monitoring, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
| | - Marcus Neudert
- Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany
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Livens P, Dirckx JJJ. Rabbit tympanic membrane thickness distribution obtained via optical coherence tomography. Hear Res 2023; 429:108701. [PMID: 36680871 DOI: 10.1016/j.heares.2023.108701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/19/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Knowing the precise tympanic membrane (TM) thickness variation is crucial in understanding the functional properties of the TM and has a significant effect on the accuracy of computational models. Using optical coherence tomography, we imaged five left and five right TMs of domestic New Zealand rabbits. From these data, ten thickness distribution maps were computed. Although inter-specimen variability is present, similar features could be observed in all samples: The rabbit TM is thickest around the umbo, with values of 150 ± 32 µm. From the umbo towards the TM annulus, the thickness gradually decreases down to 38 ± 7 µm around the midway location, but increases up to 54 ± 19 µm at the TM annulus. The thickness values at the umbo are comparable to literature data for humans, but the rabbit TM is thinner at the TM annulus and in-between the umbo and annulus. Moreover, the rabbit TM thickness distribution is highly symmetrical, which is not the case for the human TM. The results improve our general understanding of TM structure in rabbits and may improve numerical models of TM dynamical behavior.
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Affiliation(s)
- Pieter Livens
- Laboratory of Biomedical Physics (BIMEF), University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
| | - Joris J J Dirckx
- Laboratory of Biomedical Physics (BIMEF), University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
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Hamra M, Fridman L, Shinnawi S, Vaizer MC, Yelin D. In vivo optical mapping of the tympanic membrane impulse response. Hear Res 2023; 431:108723. [PMID: 36870309 DOI: 10.1016/j.heares.2023.108723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 03/01/2023]
Abstract
The wide frequency range of the human hearing could be narrowed by various pathologies in the middle ear and in the tympanic membrane that lead to conductive hearing loss. Diagnosing such hearing problems is challenging, however, often relying on subjective hearing tests supported by functional tympanometry. Here we present a method for in vivo 2D mapping of the impulse response of the tympanic membrane, and demonstrate its potential on a healthy human volunteer. The imaging technique is based on interferometric spectrally encoded endoscopy, with a handheld probe designed to scan the human tympanic membrane within less than a second. The system obtains high-resolution 2D maps of key functional parameters including peak response, rise and decay times, oscillation bandwidth and resonance frequency. We also show that the system can identify abnormal regions in the membrane by detecting differences in the local mechanical parameters of the tissue. We believe that by offering a full 2D mapping of broad-bandwidth dynamics of the tympanic membrane, the presented imaging modality would be useful for effective diagnosis of conductive hearing loss in patients.
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Affiliation(s)
- Matan Hamra
- Faculty of Biomedical Engineering, Technion - Israel institute of Technology, Haifa 3200003, Israel
| | - Lidan Fridman
- Faculty of Biomedical Engineering, Technion - Israel institute of Technology, Haifa 3200003, Israel
| | - Shadi Shinnawi
- Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Mauricio Cohen Vaizer
- Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Dvir Yelin
- Faculty of Biomedical Engineering, Technion - Israel institute of Technology, Haifa 3200003, Israel.
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Kassem F, Dagan O, Biadsee A, Masalha M, Nachmani A, Nageris B, Lee DJ, Ungar OJ, Handzel O. Possible clinical implications of the structural variations between the tympanic membrane quadrants. Laryngoscope Investig Otolaryngol 2022; 7:1164-1170. [PMID: 36000041 PMCID: PMC9392409 DOI: 10.1002/lio2.861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/17/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Retraction pockets and marginal perforations of the pars tensa of the tympanic membrane (TM) are most commonly found at superior posterior quadrant (SPQ). The patulous Eustachian tube tends to manifest in the same quadrant. Variation in the structure of the TM may explain these observations. Material and Methods A line defined by the manubrium was used to divide the pars tensa into anterior and posterior portions. A transverse line centered on the umbo divides the pars tensa into superior and inferior parts, resulting in four quadrants. Surface areas of each of the TM quadrants were measured in a sample of 23 human adult formalin-fixed temporal bones. The TMs were completely excised, faced medially, and placed against graph paper to maintain scale measurements, photoed, and measured.TM thickness was measured on a different set of 20 human temporal bones (TB) preparations with normal external and middle ears. Four random loci were chosen from each pars tensa's TM quadrant. The thickness was measured using high-magnification power microscopy. Results The SPQ was the largest and thinnest of the four quadrants. It occupies 31% of the pars tensa area. It is 69 μm as compared to approximately 85 μm in the other quadrants. The radial lines between the umbo and the annulus are in descending order from superior posterior toward the anterior-superior radials. Conclusion The SPQ has the largest vibratory area and is the thinnest of the four TM quadrants. Variation in the thickness of the middle, fibrous layer accounts for the variation in the thickness of the TM. These findings may explain the tendency of pathologies related to Eustachian tube dysfunction to preferentially manifest in or originate from the SPQ. Level of evidence 5
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Affiliation(s)
- Firas Kassem
- Department of Otolaryngology‐Head and Neck SurgeryMeir Medical CenterKfar SabaIsrael
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Or Dagan
- Department of DermatologySoroka Medical Center, Ben‐Gurion University of the NegevBeer‐ShevaIsrael
| | - Ameen Biadsee
- Department of Otolaryngology‐Head and Neck SurgeryMeir Medical CenterKfar SabaIsrael
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Department of Otolaryngology‐Head & Neck SurgeryWestern UniversityLondonOntarioCanada
| | - Muhamed Masalha
- Department of Otolaryngology‐Head and Neck SurgeryEmek Medical CenterAfulaIsrael
- The Ruth and Bruce Rappaport Faculty of Medicinethe Technion Institute of TechnologyHaifaIsrael
| | - Ariela Nachmani
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Communication Disorders FacultyHadassah Academic CollegeJerusalemIsrael
| | - Ben Nageris
- Department of Otolaryngology‐Head and Neck SurgeryMeir Medical CenterKfar SabaIsrael
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Department of communication DisordersSackler faculty of Medicine, Tel Aviv UniversityTel AvivIsrael
| | - Daniel J. Lee
- Department of Otolaryngology, Massachusetts Eye and Ear InfirmaryHarvard Medical SchoolBostonMassachusettsUSA
| | - Omer J. Ungar
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Department of Otolaryngology, Head, Neck and Maxillofacial SurgeryTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
| | - Ophir Handzel
- Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
- Department of Otolaryngology, Head, Neck and Maxillofacial SurgeryTel‐Aviv Sourasky Medical CenterTel‐AvivIsrael
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Esposito S, Bianchini S, Argentiero A, Gobbi R, Vicini C, Principi N. New Approaches and Technologies to Improve Accuracy of Acute Otitis Media Diagnosis. Diagnostics (Basel) 2021; 11:2392. [PMID: 34943628 PMCID: PMC8700495 DOI: 10.3390/diagnostics11122392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/10/2021] [Accepted: 12/17/2021] [Indexed: 12/18/2022] Open
Abstract
Several studies have shown that in recent years incidence of acute otitis media (AOM) has declined worldwide. However, related medical, social, and economic problems for patients, their families, and society remain very high. Better knowledge of potential risk factors for AOM development and more effective preventive interventions, particularly in AOM-prone children, can further reduce disease incidence. However, a more accurate AOM diagnosis seems essential to achieve this goal. Diagnostic uncertainty is common, and to avoid risks related to a disease caused mainly by bacteria, several children without AOM are treated with antibiotics and followed as true AOM cases. The main objective of this manuscript is to discuss the most common difficulties that presently limit accurate AOM diagnosis and the new approaches and technologies that have been proposed to improve disease detection. We showed that misdiagnosis can be dangerous or lead to relevant therapeutic mistakes. The need to improve AOM diagnosis has allowed the identification of a long list of technologies to visualize and evaluate the tympanic membrane and to assess middle-ear effusion. Most of the new instruments, including light field otoscopy, optical coherence tomography, low-coherence interferometry, and Raman spectroscopy, are far from being introduced in clinical practice. Video-otoscopy can be effective, especially when it is used in association with telemedicine, parents' cooperation, and artificial intelligence. Introduction of otologic telemedicine and use of artificial intelligence among pediatricians and ENT specialists must be strongly promoted in order to reduce mistakes in AOM diagnosis.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (S.B.); (A.A.)
| | - Sonia Bianchini
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (S.B.); (A.A.)
| | - Alberto Argentiero
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (S.B.); (A.A.)
| | - Riccardo Gobbi
- Head-Neck and Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Morgagni Piertoni Hospital, 47121 Forlì, Italy; (R.G.); (C.V.)
| | - Claudio Vicini
- Head-Neck and Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Morgagni Piertoni Hospital, 47121 Forlì, Italy; (R.G.); (C.V.)
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6
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Lui CG, Kim W, Dewey JB, Macías-Escrivá FD, Ratnayake K, Oghalai JS, Applegate BE. In vivo functional imaging of the human middle ear with a hand-held optical coherence tomography device. BIOMEDICAL OPTICS EXPRESS 2021; 12:5196-5213. [PMID: 34513251 PMCID: PMC8407818 DOI: 10.1364/boe.430935] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
We describe an optical coherence tomography and vibrometry system designed for portable hand-held usage in the otology clinic on awake patients. The system provides clinically relevant point-of-care morphological imaging with 14-44 µm resolution and functional vibratory measures with sub-nanometer sensitivity. We evaluated various new approaches for extracting functional information including a multi-tone stimulus, a continuous chirp stimulus, and alternating air and bone stimulus. We also explored the vibratory response over an area of the tympanic membrane (TM) and generated TM thickness maps. Our results suggest that the system can provide real-time in vivo imaging and vibrometry of the ear and could prove useful for investigating otologic pathology in the clinic setting.
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Affiliation(s)
- Christopher G. Lui
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- These authors contributed equally to this work
| | - Wihan Kim
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- These authors contributed equally to this work
| | - James B. Dewey
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Frank D. Macías-Escrivá
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Kumara Ratnayake
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - John S. Oghalai
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Brian E. Applegate
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Denney Research Center (DRB) 140, Los Angeles, CA 90089, USA
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Kashani RG, Młyńczak MC, Zarabanda D, Solis-Pazmino P, Huland DM, Ahmad IN, Singh SP, Valdez TA. Shortwave infrared otoscopy for diagnosis of middle ear effusions: a machine-learning-based approach. Sci Rep 2021; 11:12509. [PMID: 34131163 PMCID: PMC8206083 DOI: 10.1038/s41598-021-91736-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/04/2021] [Indexed: 02/05/2023] Open
Abstract
Otitis media, a common disease marked by the presence of fluid within the middle ear space, imparts a significant global health and economic burden. Identifying an effusion through the tympanic membrane is critical to diagnostic success but remains challenging due to the inherent limitations of visible light otoscopy and user interpretation. Here we describe a powerful diagnostic approach to otitis media utilizing advancements in otoscopy and machine learning. We developed an otoscope that visualizes middle ear structures and fluid in the shortwave infrared region, holding several advantages over traditional approaches. Images were captured in vivo and then processed by a novel machine learning based algorithm. The model predicts the presence of effusions with greater accuracy than current techniques, offering specificity and sensitivity over 90%. This platform has the potential to reduce costs and resources associated with otitis media, especially as improvements are made in shortwave imaging and machine learning.
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Affiliation(s)
- Rustin G. Kashani
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA
| | - Marcel C. Młyńczak
- grid.1035.70000000099214842Institute of Metrology and Biomedical Engineering, Faculty of Mechatronics, Warsaw University of Technology, Warsaw, Poland
| | - David Zarabanda
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA
| | - Paola Solis-Pazmino
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA
| | - David M. Huland
- grid.168010.e0000000419368956Department of Radiology, Stanford University School of Medicine, Palo Alto, CA USA
| | - Iram N. Ahmad
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA ,grid.414123.10000 0004 0450 875XLucile Packard Children’s Hospital, Palo Alto, CA USA
| | - Surya P. Singh
- grid.495560.b0000 0004 6003 8393Department of Biosciences and Bioengineering, Indian Institute of Technology Dharwad, Dharwad, Karnataka India
| | - Tulio A. Valdez
- grid.168010.e0000000419368956Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Road, Palo Alto, CA 94304 USA ,grid.414123.10000 0004 0450 875XLucile Packard Children’s Hospital, Palo Alto, CA USA
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Won J, Porter RG, Novak MA, Youakim J, Sum A, Barkalifa R, Aksamitiene E, Zhang A, Nolan R, Shelton R, Boppart SA. In vivo dynamic characterization of the human tympanic membrane using pneumatic optical coherence tomography. JOURNAL OF BIOPHOTONICS 2021; 14:e202000215. [PMID: 33439538 PMCID: PMC7935452 DOI: 10.1002/jbio.202000215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 05/05/2023]
Abstract
Decreased mobility of the human eardrum, the tympanic membrane (TM), is an essential indicator of a prevalent middle ear infection. The current diagnostic method to assess TM mobility is via pneumatic otoscopy, which provides subjective and qualitative information of subtle motion. In this study, a handheld spectral-domain pneumatic optical coherence tomography system was developed to simultaneously measure the displacement of the TM, air pressure inputs applied to a sealed ear canal, and to perform digital pneumatic otoscopy. A novel approach based on quantitative parameters is presented to characterize spatial and temporal variations of the dynamic TM motion. Furthermore, the TM motions of normal middle ears are compared with those of ears with middle ear infections. The capability of noninvasively measuring the rapid motion of the TM is beneficial to understand the complex dynamics of the human TM, and can ultimately lead to improved diagnosis and management of middle ear infections.
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Affiliation(s)
- Jungeun Won
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois
| | - Ryan G. Porter
- Department of Otolaryngology, Carle Foundation Hospital, Urbana, Illinois
| | - Michael A. Novak
- Department of Otolaryngology, Carle Foundation Hospital, Urbana, Illinois
| | - Jon Youakim
- Department of Pediatrics, Carle Foundation Hospital, Urbana, Illinois
| | - Ada Sum
- Department of Pediatrics, Carle Foundation Hospital, Urbana, Illinois
| | - Ronit Barkalifa
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois
| | - Edita Aksamitiene
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois
| | | | | | | | - Stephen A. Boppart
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois
- PhotoniCare, Inc., Champaign, Illinois
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois
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Hamra M, Shinnawi S, Vaizer MC, Yelin D. Rapid imaging of tympanic membrane vibrations in humans. BIOMEDICAL OPTICS EXPRESS 2020; 11:6470-6479. [PMID: 33282502 PMCID: PMC7687925 DOI: 10.1364/boe.402097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 06/12/2023]
Abstract
Functional imaging of the human ear is an extremely challenging task because of its minute anatomic structures and nanometer-scale motion in response to sound. Here, we demonstrate noninvasive in vivo functional imaging of the human tympanic membrane under various acoustic excitations, and identify unique vibration patterns that vary between human subjects. By combining spectrally encoded imaging with phase-sensitive spectral-domain interferometry, our system attains high-resolution functional imaging of the two-dimensional membrane surface, within a fraction of a second, through a handheld imaging probe. The detailed physiological data acquired by the system would allow measuring a wide range of clinically relevant parameters for patient diagnosis, and provide a powerful new tool for studying middle and inner ear physiology.
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Affiliation(s)
- Matan Hamra
- Department of Biomedical Engineering, Technion-Israel institute of Technology, Haifa 3200003, Israel
| | - Shadi Shinnawi
- Department of Otolarynglogy Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Mauricio Cohen Vaizer
- Department of Otolarynglogy Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Dvir Yelin
- Department of Biomedical Engineering, Technion-Israel institute of Technology, Haifa 3200003, Israel
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10
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SelectStitch: Automated Frame Segmentation and Stitching to Create Composite Images from Otoscope Video Clips. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10175894] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Objective: the aim of this study is to develop and validate an automated image segmentation-based frame selection and stitching framework to create enhanced composite images from otoscope videos. The proposed framework, called SelectStitch, is useful for classifying eardrum abnormalities using a single composite image instead of the entire raw otoscope video dataset. Methods: SelectStitch consists of a convolutional neural network (CNN) based semantic segmentation approach to detect the eardrum in each frame of the otoscope video, and a stitching engine to generate a high-quality composite image from the detected eardrum regions. In this study, we utilize two separate datasets: the first one has 36 otoscope videos that were used to train a semantic segmentation model, and the second one, containing 100 videos, which was used to test the proposed method. Cases from both adult and pediatric patients were used in this study. A configuration of 4-levels depth U-Net architecture was trained to automatically find eardrum regions in each otoscope video frame from the first dataset. After the segmentation, we automatically selected meaningful frames from otoscope videos by using a pre-defined threshold, i.e., it should contain at least an eardrum region of 20% of a frame size. We have generated 100 composite images from the test dataset. Three ear, nose, and throat (ENT) specialists (ENT-I, ENT-II, ENT-III) compared in two rounds the composite images produced by SelectStitch against the composite images that were generated by the base processes, i.e., stitching all the frames from the same video data, in terms of their diagnostic capabilities. Results: In the first round of the study, ENT-I, ENT-II, ENT-III graded improvement for 58, 57, and 71 composite images out of 100, respectively, for SelectStitch over the base composite, reflecting greater diagnostic capabilities. In the repeat assessment, these numbers were 56, 56, and 64, respectively. We observed that only 6%, 3%, and 3% of the cases received a lesser score than the base composite images, respectively, for ENT-I, ENT-II, and ENT-III in Round-1, and 4%, 0%, and 2% of the cases in Round-2. Conclusions: We conclude that the frame selection and stitching will increase the probability of detecting a lesion even if it appears in a few frames.
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Cho NH, Jang JH. Future Directions of Optical Coherence Tomography in Otology: A Morphological and Functional Approach. Clin Exp Otorhinolaryngol 2020; 13:85-86. [PMID: 32434305 PMCID: PMC7248606 DOI: 10.21053/ceo.2020.00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 01/18/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Nam Hyun Cho
- Department of Otolaryngology and Head-Neck Surgery, Harvard Medical School, Boston, MA, USA.,Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, USA
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
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Gisselsson-Solén M, Tähtinen PA, Ryan AF, Mulay A, Kariya S, Schilder AG, Valdez TA, Brown S, Nolan RM, Hermansson A, van Ingen G, Marom T. Panel 1: Biotechnology, biomedical engineering and new models of otitis media. Int J Pediatr Otorhinolaryngol 2020; 130 Suppl 1:109833. [PMID: 31901291 PMCID: PMC7176743 DOI: 10.1016/j.ijporl.2019.109833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To summarize recently published key articles on the topics of biomedical engineering, biotechnology and new models in relation to otitis media (OM). DATA SOURCES Electronic databases: PubMed, Ovid Medline, Cochrane Library and Clinical Evidence (BMJ Publishing). REVIEW METHODS Articles on biomedical engineering, biotechnology, material science, mechanical and animal models in OM published between May 2015 and May 2019 were identified and subjected to review. A total of 132 articles were ultimately included. RESULTS New imaging technologies for the tympanic membrane (TM) and the middle ear cavity are being developed to assess TM thickness, identify biofilms and differentiate types of middle ear effusions. Artificial intelligence (AI) has been applied to train software programs to diagnose OM with a high degree of certainty. Genetically modified mice models for OM have further investigated what predisposes some individuals to OM and consequent hearing loss. New vaccine candidates protecting against major otopathogens are being explored and developed, especially combined vaccines, targeting more than one pathogen. Transcutaneous vaccination against non-typeable Haemophilus influenzae has been successfully tried in a chinchilla model. In terms of treatment, novel technologies for trans-tympanic drug delivery are entering the clinical domain. Various growth factors and grafting materials aimed at improving healing of TM perforations show promising results in animal models. CONCLUSION New technologies and AI applications to improve the diagnosis of OM have shown promise in pre-clinical models and are gradually entering the clinical domain. So are novel vaccines and drug delivery approaches that may allow local treatment of OM. IMPLICATIONS FOR PRACTICE New diagnostic methods, potential vaccine candidates and the novel trans-tympanic drug delivery show promising results, but are not yet adapted to clinical use.
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Affiliation(s)
- Marie Gisselsson-Solén
- Department of Clinical Sciences, Division of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, Lund, Sweden
| | - Paula A. Tähtinen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Allen F. Ryan
- Division of Otolaryngology, Department of Surgery, University of California, San Diego, La Jolla, CA, USA,San Diego Veterans Affairs Healthcare System, Research Department, San Diego, CA, USA
| | - Apoorva Mulay
- The Stripp Lab, Pulmonary Department, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Shin Kariya
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Anne G.M. Schilder
- EvidENT, Ear Institute, University College London, London, UK,National Institute for Health Research University College London Biomedical Research Centre, London, UK,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tulio A. Valdez
- Department of Otolaryngology Head & Neck Surgery, Stanford University, Palo Alto, CA, USA
| | - Steve Brown
- MRC Harwell Institute, Mammalian Genetics Unit, Harwell Campus, Oxfordshire, UK
| | | | - Ann Hermansson
- Department of Clinical Sciences, Division of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, Lund, Sweden
| | - Gijs van Ingen
- Department of Otolaryngology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Faculty of Health Sciences Ben Gurion University, Ashdod, Israel.
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Preciado D, Nolan RM, Joshi R, Krakovsky GM, Zhang A, Pudik NA, Kumar NK, Shelton RL, Boppart SA, Bauman NM. Otitis Media Middle Ear Effusion Identification and Characterization Using an Optical Coherence Tomography Otoscope. Otolaryngol Head Neck Surg 2020; 162:367-374. [PMID: 31959053 DOI: 10.1177/0194599819900762] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the feasibility of detecting and differentiating middle ear effusions (MEEs) using an optical coherence tomography (OCT) otoscope. STUDY DESIGN Cross-sectional study. SETTING US tertiary care children's hospital. SUBJECTS AND METHODS Seventy pediatric patients undergoing tympanostomy tube placement were preoperatively imaged using an OCT otoscope. A blinded reader quiz was conducted using 24 readers from 4 groups of tiered medical expertise. The primary outcome assessed was reader ability to detect presence/absence of MEE. A secondary outcome assessed was reader ability to differentiate serous vs nonserous MEE. RESULTS OCT image data sets were analyzed from 45 of 70 total subjects. Blinded reader analysis of an OCT data subset for detection of MEE resulted in 90.6% accuracy, 90.9% sensitivity, 90.2% specificity, and intra/interreader agreement of 92.9% and 87.1%, respectively. Differentiating MEE type, reader identification of nonserous MEE had 70.8% accuracy, 53.6% sensitivity, 80.1% specificity, and intra/interreader agreement of 82.9% and 75.1%, respectively. Multivariate analysis revealed that age was the strongest predictor of OCT quality. The mean age of subjects with quality OCT was 5.01 years (n = 45), compared to 2.54 years (n = 25) in the remaining subjects imaged (P = .0028). The ability to capture quality images improved over time, from 50% to 69.4% over the study period. CONCLUSION OCT otoscopy shows promise for facilitating accurate MEE detection. The imageability with the prototype device was affected by age, with older children being easier to image, similar to current ear diagnostic technologies.
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Affiliation(s)
- Diego Preciado
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA.,Sheikh Zayed Institute, CNHS, Washington, DC, USA
| | | | - Radhika Joshi
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA.,Sheikh Zayed Institute, CNHS, Washington, DC, USA
| | - Gina M Krakovsky
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA
| | | | | | | | | | | | - Nancy M Bauman
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA
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Novozhilov AA, Shilyagin PA, Shakhov AV, Gelikonov VM. [Overview of modern methods for the diagnosis of exudative otitis media]. Vestn Otorinolaringol 2020; 85:68-74. [PMID: 32628387 DOI: 10.17116/otorino20208503168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Modern methods for diagnosis of exudative otitis media (EOM) have great potential, however, the problem of diagnosis of EOM is still relevant. The article describes the methods of modern diagnostics that are widely used in the daily practice of an otolaryngologist. The basic principles, advantages and disadvantages of generally accepted diagnostic methods for EOM are presented. The method of optical coherence tomography (OCT) is described as a method of studying biological tissues, which is used in many fields of medicine. Information is provided on the possibilities of OCT in the diagnosis of diseases of the ENT organs and, in particular, of the middle ear. The results of studies of the tympanic cavity structures in various inflammatory conditions, the possibilities of intrasurgery use of OCT, as well as the possibilities and perspectives of introducing OCT into the practice of an otorhinolaryngologist in the diagnosis of exudative otitis media are described.
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Affiliation(s)
- A A Novozhilov
- Privolzhsky Regional Medical Center of the FMBA of Russia, Nizhny Novgorod, Russia
- Institute of Applied Physics of RAS, Nizhny Novgorod, Russia
| | - P A Shilyagin
- Institute of Applied Physics of RAS, Nizhny Novgorod, Russia
| | - A V Shakhov
- Privolzhsky Regional Medical Center of the FMBA of Russia, Nizhny Novgorod, Russia
- Institute of Applied Physics of RAS, Nizhny Novgorod, Russia
- Privolzhsky Research Medical University of the Ministry of Health of Russia, Nizhny Novgorod, Russia
| | - V M Gelikonov
- Institute of Applied Physics of RAS, Nizhny Novgorod, Russia
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15
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Marom T, Kraus O, Habashi N, Tamir SO. Emerging Technologies for the Diagnosis of Otitis Media. Otolaryngol Head Neck Surg 2018; 160:447-456. [PMID: 30396324 DOI: 10.1177/0194599818809337] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To review new experimental techniques for the diagnosis of otitis media (OM). DATA SOURCES Literature search in English in the following databases: MEDLINE (via PubMed), Ovid Medline, Google Scholar, and Clinical Evidence (BMJ Publishing) between January 1, 2005, and April 30, 2018. Subsequently, articles were reviewed and included only if relevant. REVIEW METHODS MeSH terms: ["diagnosis"] AND [all forms of OM] AND ["human"] AND ["ear"] and ["tympanic membrane"]. The retrieved innovative diagnostic techniques rely on and take advantage of the physical properties of the tympanomastoid cavity components: tympanic membrane (TM) thickness, its translucency and compliance; middle ear fluid characteristics; biofilm presence; increased tissue metabolic activity in OM states; and fluid presence in the mastoid cavity. These parameters are taken into account to establish OM diagnosis objectively. We review spectral gradient acoustic reflectometry, digital otoscopy, TM image analysis, multicolor reflectance imaging, anticonfocal middle ear assessment, optical coherence tomography, quantitative pneumatic otoscopy, transmastoid ultrasound, wideband measurements, TM thickness mapping, shortwave infrared imaging, and wideband acoustic transfer functions. CONCLUSIONS New experimental techniques are gradually introduced to overcome the limitations of standard otoscopy. The aforementioned techniques are still under investigation and are pending widespread clinical use. The implementation of these techniques in the market is dependent on their success in clinical trials, as well as on their future cost. IMPLICATION FOR PRACTICE New techniques for the diagnosis of OM can objectively evaluate the morphology of the TM, determine the presence of middle ear fluid and evaluate its content, and thus potentially replace standard otoscopy.
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Affiliation(s)
- Tal Marom
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Oded Kraus
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Nadeem Habashi
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
| | - Sharon Ovnat Tamir
- 1 Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben Gurion University Faculty of Health Sciences, Ashdod, Israel
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16
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Dsouza R, Won J, Monroy GL, Spillman DR, Boppart SA. Economical and compact briefcase spectral-domain optical coherence tomography system for primary care and point-of-care applications. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-11. [PMID: 30251484 PMCID: PMC6170142 DOI: 10.1117/1.jbo.23.9.096003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 08/29/2018] [Indexed: 05/28/2023]
Abstract
Development of low-cost and portable optical coherence tomography (OCT) systems is of global interest in the OCT research community. Such systems enable utility broadly throughout a clinical facility, or in remote areas that often lack clinical infrastructure. We report the development and validation of a low-cost, portable briefcase spectral-domain optical coherence tomography (SD-OCT) system for point-of-care diagnostics in primary care centers and/or in remote settings. The self-contained briefcase OCT contains all associated optical hardware, including light source, spectrometer, hand-held probe, and a laptop. Additionally, this system utilizes unique real-time mosaicking of surface video images that are synchronized with rapid A-scan acquisition to eliminate the need for lateral scanning hardware, and enable the construction of cross-sectional B-mode images over extended lateral distances. The entire briefcase system weighs 9 kg and costs ∼USD$8000 using off-the-shelf components. System performance was validated by acquiring images of in vivo human skin on the fingertip, palm, and nail fold. The efficiency, portability, and low-cost enable accessibility and utility in primary care centers and low-resource settings.
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Affiliation(s)
- Roshan Dsouza
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Jungeun Won
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Guillermo L. Monroy
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Darold R. Spillman
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Stephen A. Boppart
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle-Illinois College of Medicine, Urbana, Illinois, United States
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17
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Tan HEI, Santa Maria PL, Wijesinghe P, Francis Kennedy B, Allardyce BJ, Eikelboom RH, Atlas MD, Dilley RJ. Optical Coherence Tomography of the Tympanic Membrane and Middle Ear: A Review. Otolaryngol Head Neck Surg 2018; 159:424-438. [PMID: 29787354 DOI: 10.1177/0194599818775711] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective To evaluate the recent developments in optical coherence tomography (OCT) for tympanic membrane (TM) and middle ear (ME) imaging and to identify what further development is required for the technology to be integrated into common clinical use. Data Sources PubMed, Embase, Google Scholar, Scopus, and Web of Science. Review Methods A comprehensive literature search was performed for English language articles published from January 1966 to January 2018 with the keywords "tympanic membrane or middle ear,""optical coherence tomography," and "imaging." Conclusion Conventional imaging techniques cannot adequately resolve the microscale features of TM and ME, sometimes necessitating diagnostic exploratory surgery in challenging otologic pathology. As a high-resolution noninvasive imaging technique, OCT offers promise as a diagnostic aid for otologic conditions, such as otitis media, cholesteatoma, and conductive hearing loss. Using OCT vibrometry to image the nanoscale vibrations of the TM and ME as they conduct acoustic waves may detect the location of ossicular chain dysfunction and differentiate between stapes fixation and incus-stapes discontinuity. The capacity of OCT to image depth and thickness at high resolution allows 3-dimensional volumetric reconstruction of the ME and has potential use for reconstructive tympanoplasty planning and the follow-up of ossicular prostheses. Implications for Practice To achieve common clinical use beyond these initial discoveries, future in vivo imaging devices must feature low-cost probe or endoscopic designs and faster imaging speeds and demonstrate superior diagnostic utility to computed tomography and magnetic resonance imaging. While such technology has been available for OCT, its translation requires focused development through a close collaboration between engineers and clinicians.
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Affiliation(s)
- Hsern Ern Ivan Tan
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia.,3 Department of Otolaryngology-Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, Australia
| | - Peter Luke Santa Maria
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia.,4 Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Philip Wijesinghe
- 5 BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre; Centre for Medical Research, The University of Western Australia, Nedlands, Australia.,6 Department of Electrical, Electronic, and Computer Engineering, School of Engineering, The University of Western Australia, Nedlands, Australia
| | - Brendan Francis Kennedy
- 5 BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre; Centre for Medical Research, The University of Western Australia, Nedlands, Australia.,6 Department of Electrical, Electronic, and Computer Engineering, School of Engineering, The University of Western Australia, Nedlands, Australia
| | | | - Robert Henry Eikelboom
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia.,8 Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Marcus David Atlas
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia
| | - Rodney James Dilley
- 1 Ear Science Institute Australia, Subiaco, Australia.,2 Ear Sciences Centre, School of Medicine, The University of Western Australia, Nedlands, Australia
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18
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Monroy GL, Won J, Spillman DR, Dsouza R, Boppart SA. Clinical translation of handheld optical coherence tomography: practical considerations and recent advancements. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-30. [PMID: 29260539 PMCID: PMC5735247 DOI: 10.1117/1.jbo.22.12.121715] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/04/2017] [Indexed: 05/21/2023]
Abstract
Since the inception of optical coherence tomography (OCT), advancements in imaging system design and handheld probes have allowed for numerous advancements in disease diagnostics and characterization of the structural and optical properties of tissue. OCT system developers continue to reduce form factor and cost, while improving imaging performance (speed, resolution, etc.) and flexibility for applicability in a broad range of fields, and nearly every clinical specialty. An extensive array of components to construct customized systems has also become available, with a range of commercial entities that produce high-quality products, from single components to full systems, for clinical and research use. Many advancements in the development of these miniaturized and portable systems can be linked back to a specific challenge in academic research, or a clinical need in medicine or surgery. Handheld OCT systems are discussed and explored for various applications. Handheld systems are discussed in terms of their relative level of portability and form factor, with mention of the supporting technologies and surrounding ecosystem that bolstered their development. Additional insight from our efforts to implement systems in several clinical environments is provided. The trend toward well-designed, efficient, and compact handheld systems paves the way for more widespread adoption of OCT into point-of-care or point-of-procedure applications in both clinical and commercial settings.
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Affiliation(s)
- Guillermo L. Monroy
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Jungeun Won
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Darold R. Spillman
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Roshan Dsouza
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- Carle-Illinois College of Medicine, Urbana, Illinois, United States
- Address all correspondence to: Stephen A. Boppart, E-mail:
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19
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Monroy GL, Pande P, Nolan RM, Shelton RL, Porter RG, Novak MA, Spillman DR, Chaney EJ, McCormick DT, Boppart SA. Noninvasive in vivo optical coherence tomography tracking of chronic otitis media in pediatric subjects after surgical intervention. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-11. [PMID: 29275547 PMCID: PMC5745859 DOI: 10.1117/1.jbo.22.12.121614] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 12/15/2017] [Indexed: 05/12/2023]
Abstract
In an institutional review board-approved study, 25 pediatric subjects diagnosed with chronic or recurrent otitis media were observed over a period of six months with optical coherence tomography (OCT). Subjects were followed throughout their treatment at the initial patient evaluation and preoperative consultation, surgery (intraoperative imaging), and postoperative follow-up, followed by an additional six months of records-based observation. At each time point, the tympanic membrane (at the light reflex region) and directly adjacent middle-ear cavity were observed in vivo with a handheld OCT probe and portable system. Imaging results were compared with clinical outcomes to correlate the clearance of symptoms in relation to changes in the image-based features of infection. OCT images of most all participants showed the presence of additional infection-related biofilm structures during their initial consultation visit and similarly for subjects imaged intraoperatively before myringotomy. Subjects with successful treatment (no recurrence of infectious symptoms) had no additional structures visible in OCT images during the postoperative visit. OCT image findings suggest surgical intervention consisting of myringotomy and tympanostomy tube placement provides a means to clear the middle ear of infection-related components, including middle-ear fluid and biofilms. Furthermore, OCT was demonstrated as a rapid diagnostic tool to prospectively monitor patients in both outpatient and surgical settings.
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Affiliation(s)
- Guillermo L. Monroy
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Paritosh Pande
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Ryan M. Nolan
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Ryan L. Shelton
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
| | - Ryan G. Porter
- Carle Foundation Hospital, Department of Otolaryngology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
| | - Michael A. Novak
- Carle Foundation Hospital, Department of Otolaryngology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
| | - Darold R. Spillman
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Eric J. Chaney
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | | | - Stephen A. Boppart
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle–Illinois College of Medicine, Urbana, Illinois, United States
- Address all correspondence to: Stephen A. Boppart, E-mail:
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20
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Gora MJ, Suter MJ, Tearney GJ, Li X. Endoscopic optical coherence tomography: technologies and clinical applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2017; 8:2405-2444. [PMID: 28663882 PMCID: PMC5480489 DOI: 10.1364/boe.8.002405] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 05/07/2023]
Abstract
In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed.
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Affiliation(s)
- Michalina J Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- ICube Laboratory, CNRS, Strasbourg University, 1 Place de l'Hopital, Strasbourg 67091, France
| | - Melissa J Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Department of Medicine, Division of Pulmonary and Critical Care, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Xingde Li
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, and Department of Oncology, Johns Hopkins University, 720 Rutland Avenue, Traylor 710, Baltimore, MD 21205, USA
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21
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Pande P, Shelton RL, Monroy GL, Nolan RM, Boppart SA. Low-cost hand-held probe for depth-resolved low-coherence interferometry. BIOMEDICAL OPTICS EXPRESS 2017; 8:338-348. [PMID: 28101422 PMCID: PMC5231303 DOI: 10.1364/boe.8.000338] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 05/20/2023]
Abstract
We report on the development of a low-cost hand-held low-coherence interferometric imaging system based on the principle of linear optical coherence tomography (Linear OCT), a technique which was first proposed in the early 2000s as a simpler alternative to the conventional time-domain and Fourier-domain OCT. A bench-top implementation of the proposed technique is first presented and validated. The axial resolution, SNR, and sensitivity roll-of of the system was estimated to be 5.2 μm and 80 dB, and 3.7 dB over a depth of 0.15 mm, respectively. After validating the bench-top system, two hand-held probe implementations for contact-based imaging and in vivo human tympanic membrane imaging are presented. The performance of the proposed system was compared with a research-grade state-of-the-art Fourier-domain low coherence interferometry (LCI) system by imaging several biological and non-biological samples. The results of this study suggest that the proposed system might be a suitable choice for applications where imaging depth and SNR can be traded for lower cost and simpler optical design.
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Affiliation(s)
- Paritosh Pande
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
| | - Ryan L. Shelton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
| | - Guillermo L. Monroy
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
| | - Ryan M. Nolan
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
| | - Stephen A. Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
- Department of Internal Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois,
USA
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