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Wang J, Farrell J, Couvreur F, Yang X, Shoman N, Morris DP, Adamson RBA. Clinical Applications of Handheld Middle Ear Optical Coherence Tomography (ME-OCT) With Live Volumetric Visualization: Clinical Applications of 4D ME-OCT. Otol Neurotol 2024; 45:e497-e498. [PMID: 38865730 DOI: 10.1097/mao.0000000000004188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Affiliation(s)
- Junzhe Wang
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joshua Farrell
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Xiaojie Yang
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Nael Shoman
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David P Morris
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
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Remenschneider A, Cheng JT. Contemporary Mechanics of Conductive Hearing Loss. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY--HEAD AND NECK SURGERY 2024; 35:2-10. [PMID: 38680732 PMCID: PMC11052546 DOI: 10.1016/j.otot.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The middle ear plays a critical role for the conversion of acoustic energy to mechanical vibrations that subsequently enter the cochlea. It is middle ear impedance matching through ossicular coupling that has enabled land-dwelling vertebrates to hear soft airborne sounds. Conductive hearing loss may result from damage to the delicate middle ear structures following infection, trauma or rapid pressure changes. An understanding of the mechanics of the middle ear significantly improves the oto-surgeon's ability to effectively diagnose conductive hearing loss, localize the responsible lesion and then effectively correct the conduction abnormality. This article reviews some of the basic knowledge of middle ear mechanics for sound transmission, highlights recent advances in developing new techniques to assist in diagnosis of middle ear disease, and finally sheds light on future research aimed at improving the diagnosis and management of middle ear pathology.
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Affiliation(s)
- Aaron Remenschneider
- Department of otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA
- Department of otolaryngology, head and neck surgery, Harvard Medical School, Boston, MA
- Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA
| | - Jeffrey Tao Cheng
- Department of otolaryngology, head and neck surgery, Harvard Medical School, Boston, MA
- Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA
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Zhou Z, Pandey R, Valdez TA. Label-Free Optical Technologies for Middle-Ear Diseases. Bioengineering (Basel) 2024; 11:104. [PMID: 38391590 PMCID: PMC10885954 DOI: 10.3390/bioengineering11020104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 02/24/2024] Open
Abstract
Medical applications of optical technology have increased tremendously in recent decades. Label-free techniques have the unique advantage of investigating biological samples in vivo without introducing exogenous agents. This is especially beneficial for a rapid clinical translation as it reduces the need for toxicity studies and regulatory approval for exogenous labels. Emerging applications have utilized label-free optical technology for screening, diagnosis, and surgical guidance. Advancements in detection technology and rapid improvements in artificial intelligence have expedited the clinical implementation of some optical technologies. Among numerous biomedical application areas, middle-ear disease is a unique space where label-free technology has great potential. The middle ear has a unique anatomical location that can be accessed through a dark channel, the external auditory canal; it can be sampled through a tympanic membrane of approximately 100 microns in thickness. The tympanic membrane is the only membrane in the body that is surrounded by air on both sides, under normal conditions. Despite these favorable characteristics, current examination modalities for middle-ear space utilize century-old technology such as white-light otoscopy. This paper reviews existing label-free imaging technologies and their current progress in visualizing middle-ear diseases. We discuss potential opportunities, barriers, and practical considerations when transitioning label-free technology to clinical applications.
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Affiliation(s)
- Zeyi Zhou
- School of Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Rishikesh Pandey
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Tulio A Valdez
- Department of Otolaryngology, Stanford University, Palo Alto, CA 94304, USA
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Oghalai TP, Long R, Kim W, Applegate BE, Oghalai JS. Automated Segmentation of Optical Coherence Tomography Images of the Human Tympanic Membrane Using Deep Learning. ALGORITHMS 2023; 16:445. [PMID: 39104565 PMCID: PMC11299891 DOI: 10.3390/a16090445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
Optical Coherence Tomography (OCT) is a light-based imaging modality that is used widely in the diagnosis and management of eye disease, and it is starting to become used to evaluate for ear disease. However, manual image analysis to interpret the anatomical and pathological findings in the images it provides is complicated and time-consuming. To streamline data analysis and image processing, we applied a machine learning algorithm to identify and segment the key anatomical structure of interest for medical diagnostics, the tympanic membrane. Using 3D volumes of the human tympanic membrane, we used thresholding and contour finding to locate a series of objects. We then applied TensorFlow deep learning algorithms to identify the tympanic membrane within the objects using a convolutional neural network. Finally, we reconstructed the 3D volume to selectively display the tympanic membrane. The algorithm was able to correctly identify the tympanic membrane properly with an accuracy of ~98% while removing most of the artifacts within the images, caused by reflections and signal saturations. Thus, the algorithm significantly improved visualization of the tympanic membrane, which was our primary objective. Machine learning approaches, such as this one, will be critical to allowing OCT medical imaging to become a convenient and viable diagnostic tool within the field of otolaryngology.
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Affiliation(s)
- Thomas P. Oghalai
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Ryan Long
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Wihan Kim
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Brian E. Applegate
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - John S. Oghalai
- Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
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Meenderink SWF, Warn M, Anchondo LM, Liu Y, Jung TTK, Dong W. Assessment of middle ear structure and function with optical coherence tomography. Acta Otolaryngol 2023; 143:558-562. [PMID: 37366291 DOI: 10.1080/00016489.2023.2224846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Current clinical tests for middle ear (ME) injuries and related conductive hearing loss (CHL) are lengthy and costly, lacking the ability to noninvasively evaluate both structure and function in real time. Optical coherence tomography (OCT) provides both, but its application to the audiological clinic is currently limited. OBJECTIVE Adapt and use a commercial Spectral-Domain OCT (SD-OCT) to evaluate anatomy and sound-evoked vibrations of the tympanic membrane (TM) and ossicles in the human ME. MATERIALS AND METHODS SD-OCT was used to capture high-resolution three-dimensional (3D) ME images and measure sound-induced vibrations of the TM and ossicles in fresh human temporal bones. RESULTS The 3D images provided thickness maps of the TM. The system was, with some software adaptations, also capable of phase-sensitive vibrometry. Measurements revealed several modes of TM vibration that became more complex with frequency. Vibrations were also measured from the incus, through the TM. This quantified ME sound transmission, which is the essential measure to assess CHL. CONCLUSION AND SIGNIFICANCE We adapted a commercial SD-OCT to visualize the anatomy and function of the human ME. OCT has the potential to revolutionize point-of-care assessment of ME disruptions that lead to CHL which are otherwise indistinguishable via otoscopy.
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Affiliation(s)
| | - Michael Warn
- University of California Riverside School of Medicine, Riverside, CA, USA
| | | | - Yuan Liu
- Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA
| | - Timothy T K Jung
- VA Loma Linda Healthcare System, Loma Linda, CA, USA
- Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA
| | - Wei Dong
- VA Loma Linda Healthcare System, Loma Linda, CA, USA
- Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA
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Farrell JD, Wang J, MacDougall D, Yang X, Brewer K, Couvreur F, Shoman N, Morris DP, Adamson RBA. Geometrically accurate real-time volumetric visualization of the middle ear using optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2023; 14:3152-3171. [PMID: 37497518 PMCID: PMC10368046 DOI: 10.1364/boe.488845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 07/28/2023]
Abstract
We introduce a novel system for geometrically accurate, continuous, live, volumetric middle ear optical coherence tomography imaging over a 10.9mm×30∘×30∘ field of view (FOV) from a handheld imaging probe. The system employs a discretized spiral scanning (DC-SC) pattern to rapidly collect volumetric data and applies real-time scan conversion and lateral angular distortion correction to reduce geometric inaccuracies to below the system's lateral resolution over 92% of the FOV. We validate the geometric accuracy of the resulting images through comparison with co-registered micro-computed tomography (micro-CT) volumes of a phantom target and a cadaveric middle ear. The system's real-time volumetric imaging capabilities are assessed by imaging the ear of a healthy subject while performing dynamic pressurization of the middle ear in a Valsalva maneuver.
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Affiliation(s)
- Joshua D. Farrell
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
| | - Junzhe Wang
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
| | - Dan MacDougall
- Audioptics Medical Incorporated, 1344 Summer St, Halifax NS, B3H 0A8, Canada
| | - Xiaojie Yang
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
| | - Kimberly Brewer
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
- Department of Diagnostic Radiology, Microbiology & Immunology, Physics & Atmospheric Science, Dalhousie University, Halifax NS, B3H 4R2, Canada
| | - Floor Couvreur
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax NS B3H 4R2, Canada
- Department of Otorhinolaryngology, Head and Neck Surgery, AZ Sint-Jan’s Hospital, Ruddershove 10, 8000 Bruges, Belgium
| | - Nael Shoman
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax NS B3H 4R2, Canada
| | - David P Morris
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax NS B3H 4R2, Canada
| | - Robert B. A. Adamson
- School of Biomedical Engineering, Dalhousie University, NS B3H 4R2, Canada
- Electrical and Computer Engineering Department, Dalhousie University, Halifax, NS B3H 4R2, Canada
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Mirmosayyeb O, Zivadinov R, Weinstock-Guttman B, Benedict RHB, Jakimovski D. Optical coherence tomography (OCT) measurements and cognitive performance in multiple sclerosis: a systematic review and meta-analysis. J Neurol 2023; 270:1266-1285. [PMID: 36396812 DOI: 10.1007/s00415-022-11449-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Several studies report mixed associations between the retinal nerve fiber layer (RNFL) thickness with cognitive and physical disability in persons with multiple sclerosis (PwMS). Systematic synthesis of these findings is crucial in deriving credible conclusions. METHODS Five databases were searched from their inception to March 2022. The inclusion criteria for studies were MS-specific and required RNFL and cognitive performance data in order to be analyzed. The selection processes followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS The systematic review yielded 31 studies that investigated the association between RNFL thickness and cognitive performance. Twenty-two studies reported positive associations, and nine did not. The meta-analysis included 11 studies with a total of 782 PwMS with mean age of 40.5 years, mean Expanded Disability Status Scale (EDSS) of 2.7, and disease duration of 11.3 years. RNFL thickness was significantly associated Symbol Digit Modalities Test (pooled r = 0.306, p < 0.001), Paced Auditory Serial Addition Test (pooled r = 0.374, p < 0.001) and Word List Generation (WLG, pooled r = 0.177, p < 0.001). RNFL was also significantly correlated with visuospatial learning and memory tests (pooled r = 0.148, p = 0.042) and verbal learning and memory tests (pooled r = 0.245, p = 0.005). Within three eligible studies, no significant association between ganglion cell inner-plexiform layer and SDMT 0.083 (95% CI - 0.186, 0.352) was noted. The heterogeneity was high in all correlation studies (I2 > 63% and p < 0.008) except for the WLG and visuospatial memory findings. CONCLUSION RNFL thickness is associated with cognitive processing speed, verbal learning and memory, visual learning and memory, as well as verbal fluency in PwMS. The number of studies included in the meta-analyses were limited due to non-standardized reporting.
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Affiliation(s)
- Omid Mirmosayyeb
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA
- Center for Biomedical Imaging at the Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Ralph H B Benedict
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Dejan Jakimovski
- Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA.
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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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Hidaka H, Ito M, Ikeda R, Kamide Y, Kuroki H, Nakano A, Yoshida H, Takahashi H, Iino Y, Harabuchi Y, Kobayashi H. Clinical practice guidelines for the diagnosis and management of otitis media with effusion (OME) in children in Japan - 2022 update. Auris Nasus Larynx 2022:S0385-8146(22)00232-2. [PMID: 36577619 DOI: 10.1016/j.anl.2022.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/28/2022]
Abstract
This is an update of the 2015 Guidelines developed by the Japan Otological Society and Oto-Rhino-Laryngeal Society of Japan defining otitis media with effusion (OME) in children (younger than 12 years old) and describing the disease rate, diagnosis, and method of examination. Recommended therapies that received consensus from the guideline committee were updated in consideration of current therapies used in Japan and based on available evidence. METHOD Regarding the treatment of OME in children, we developed Clinical Questions (CQs) and retrieved documents on each theme, including the definition, disease state, method of diagnosis, and medical treatment. In the previous guidelines, no retrieval expression was used to designate a period of time for literature retrieval. Conversely, a literature search of publications from March 2014 to May 2019 has been added to the JOS 2015 Guidelines. For publication of the CQs, we developed and assigned strengths to recommendations based on the collected evidence. RESULTS OME in children was classified into one group lacking the risk of developing chronic or intractable disease and another group at higher risk (e.g., children with Down syndrome, cleft palate), and recommendations for clinical management, including follow-up, is provided. Information regarding management of children with unilateral OME and intractable cases complicated by adhesive otitis media is also provided. CONCLUSION In clinical management of OME in children, the Japanese Clinical Practice Guidelines recommends management not only of complications of OME itself, such as effusion in the middle ear and pathologic changes in the tympanic membrane, but also pathologic changes in surrounding organs associated with infectious or inflammatory diseases.
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Affiliation(s)
- Hiroshi Hidaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan.
| | - Makoto Ito
- Department of Pediatric Otolaryngology, Jichi Children's Medical Center Tochigi, Jichi Medical University, Japan
| | - Ryoukichi Ikeda
- Department of Otolaryngology-Head & Neck Surgery, Iwate Medical University, Japan
| | | | | | - Atsuko Nakano
- Division of Otorhinolaryngology, Chiba Children's Hospital, Japan
| | - Haruo Yoshida
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University School of Medicine, Japan
| | - Haruo Takahashi
- Department of Otolaryngology Head and Neck Surgery, Nagasaki University School of Medicine, Japan
| | - Yukiko Iino
- Department of Otolaryngology, Tokyo-Kita Medical Center, Japan
| | - Yasuaki Harabuchi
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Japan
| | - Hitome Kobayashi
- Department of Otorhinolaryngology, Showa University School of Medicine, Japan
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Starovoyt A, Quirk BC, Putzeys T, Kerckhofs G, Nuyts J, Wouters J, McLaughlin RA, Verhaert N. An optically-guided cochlear implant sheath for real-time monitoring of electrode insertion into the human cochlea. Sci Rep 2022; 12:19234. [PMID: 36357503 PMCID: PMC9649659 DOI: 10.1038/s41598-022-23653-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022] Open
Abstract
In cochlear implant surgery, insertion of perimodiolar electrode arrays into the scala tympani can be complicated by trauma or even accidental translocation of the electrode array within the cochlea. In patients with partial hearing loss, cochlear trauma can not only negatively affect implant performance, but also reduce residual hearing function. These events have been related to suboptimal positioning of the cochlear implant electrode array with respect to critical cochlear walls of the scala tympani (modiolar wall, osseous spiral lamina and basilar membrane). Currently, the position of the electrode array in relation to these walls cannot be assessed during the insertion and the surgeon depends on tactile feedback, which is unreliable and often comes too late. This study presents an image-guided cochlear implant device with an integrated, fiber-optic imaging probe that provides real-time feedback using optical coherence tomography during insertion into the human cochlea. This novel device enables the surgeon to accurately detect and identify the cochlear walls ahead and to adjust the insertion trajectory, avoiding collision and trauma. The functionality of this prototype has been demonstrated in a series of insertion experiments, conducted by experienced cochlear implant surgeons on fresh-frozen human cadaveric cochleae.
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Affiliation(s)
- Anastasiya Starovoyt
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Bryden C. Quirk
- grid.1010.00000 0004 1936 7304Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005 Australia ,grid.1010.00000 0004 1936 7304Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Tristan Putzeys
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Laboratory for Soft Matter and Biophysics, Department of Physics and Astronomy, KU Leuven, 3000 Leuven, Belgium
| | - Greet Kerckhofs
- grid.7942.80000 0001 2294 713XBiomechanics Laboratory, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, 1348 Louvain-La-Neuve, Belgium ,grid.5596.f0000 0001 0668 7884Department of Materials Science and Engineering, KU Leuven, 3000 Leuven, Belgium ,grid.7942.80000 0001 2294 713XInstitute of Experimental and Clinical Research, UCLouvain, 1200 Woluwé-Saint-Lambert, Belgium ,grid.5596.f0000 0001 0668 7884Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, 3000 Leuven, Belgium
| | - Johan Nuyts
- grid.5596.f0000 0001 0668 7884Department of Imaging and Pathology, Division of Nuclear Medicine, KU Leuven, 3000 Leuven, Belgium ,Nuclear Medicine and Molecular Imaging, Medical Imaging Research Center, 3000 Leuven, Belgium
| | - Jan Wouters
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Robert A. McLaughlin
- grid.1010.00000 0004 1936 7304Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005 Australia ,grid.1010.00000 0004 1936 7304Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA 5005 Australia ,grid.1012.20000 0004 1936 7910School of Engineering, University of Western Australia, Perth, WA 6009 Australia
| | - Nicolas Verhaert
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, 3000 Leuven, Belgium
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Transtympanic Visualization of Cochlear Implant Placement With Optical Coherence Tomography: A Pilot Study. Otol Neurotol 2022; 43:e824-e828. [PMID: 35970156 DOI: 10.1097/mao.0000000000003635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to evaluate the ability of transtympanic middle ear optical coherence tomography (ME-OCT) to assess placement of cochlear implants (CIs) in situ. PATIENT A 72-year-old man with bilateral progressive heredodegenerative sensorineural hearing loss due to work-related noise exposure received a CI with a slim modiolar electrode for his right ear 3 months before his scheduled checkup. INTERVENTION A custom-built swept source ME-OCT system (λo = 1550 nm, ∆λ = 40 nm) designed for transtympanic middle ear imaging was used to capture a series of two- and three-dimensional images of the patient's CI in situ. Separately, transtympanic OCT two-dimensional video imaging and three-dimensional imaging were used to visualize insertion and removal of a CI with a slim modiolar electrode in a human cadaveric temporal bone through a posterior tympanotomy. MAIN OUTCOME MEASURE Images and video were analyzed qualitatively to determine the visibility of implant features under ME-OCT imaging and quantitatively to determine insertion depth of the CI. RESULTS After implantation, the CI electrode could be readily visualized in the round window niche under transtympanic ME-OCT in both the patient and the temporal bone. In both cases, characteristic design features of the slim modiolar electrode allowed us to quantify the insertion depth from our images. CONCLUSIONS ME-OCT could potentially be used in a clinic as a noninvasive, nonionizing means to confirm implant placement. This study shows that features of the CI electrode visible under ME-OCT can be used to quantify insertion depth in the postoperative ear.
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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] [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 Surgery Meir Medical Center Kfar Saba Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - Or Dagan
- Department of Dermatology Soroka Medical Center, Ben‐Gurion University of the Negev Beer‐Sheva Israel
| | - Ameen Biadsee
- Department of Otolaryngology‐Head and Neck Surgery Meir Medical Center Kfar Saba Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Otolaryngology‐Head & Neck Surgery Western University London Ontario Canada
| | - Muhamed Masalha
- Department of Otolaryngology‐Head and Neck Surgery Emek Medical Center Afula Israel
- The Ruth and Bruce Rappaport Faculty of Medicine the Technion Institute of Technology Haifa Israel
| | - Ariela Nachmani
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Communication Disorders Faculty Hadassah Academic College Jerusalem Israel
| | - Ben Nageris
- Department of Otolaryngology‐Head and Neck Surgery Meir Medical Center Kfar Saba Israel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of communication Disorders Sackler faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Daniel J. Lee
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary Harvard Medical School Boston Massachusetts USA
| | - Omer J. Ungar
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Otolaryngology, Head, Neck and Maxillofacial Surgery Tel‐Aviv Sourasky Medical Center Tel‐Aviv Israel
| | - Ophir Handzel
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
- Department of Otolaryngology, Head, Neck and Maxillofacial Surgery Tel‐Aviv Sourasky Medical Center Tel‐Aviv Israel
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13
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Otuya DO, Dechene NM, Poshtupaka D, Judson S, Carlson CJ, Zemlok SK, Sevieri E, Choy P, Shore RE, De León-Peralta E, Cirio AA, Rihm TW, Krall AA, Gavgiotaki E, Dong J, Silva SL, Baillargeon A, Baldwin G, Gao AH, Jansa Z, Barrios A, Ryan E, Bhat NGM, Balmasheva I, Chung A, Grant CN, Bablouzian AL, Beatty M, Ahsen OO, Zheng H, Tearney GJ. Passively scanned, single-fiber optical coherence tomography probes for gastrointestinal devices. Lasers Surg Med 2022; 54:935-944. [PMID: 35708124 PMCID: PMC9541095 DOI: 10.1002/lsm.23576] [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: 03/25/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 10/25/2022]
Abstract
BACKGROUND/OBJECTIVES Optical coherence tomography (OCT) uses low coherence interferometry to obtain depth-resolved tissue reflectivity profiles (M-mode) and transverse beam scanning to create images of two-dimensional tissue morphology (B-mode). Endoscopic OCT imaging probes typically employ proximal or distal mechanical beam scanning mechanisms that increase cost, complexity, and size. Here, we demonstrate in the gastrointestinal (GI) tracts of unsedated human patients, that a passive, single-fiber probe can be used to guide device placement, conduct device-tissue physical contact sensing, and obtain two-dimensional OCT images via M-to-B-mode conversion. MATERIALS AND METHODS We designed and developed ultrasmall, manually scannable, side- and forward-viewing single fiber-optic probes that can capture M-mode OCT data. Side-viewing M-mode OCT probes were incorporated into brush biopsy devices designed to harvest the microbiome and forward-viewing M-mode OCT probes were integrated into devices that measure intestinal potential difference (IPD). The M-mode OCT probe-coupled devices were utilized in the GI tract in six unsedated patients in vivo. M-mode data were converted into B-mode images using an M-to-B-mode conversion algorithm. The effectiveness of physical contact sensing by the M-mode OCT probes was assessed by comparing the variances of the IPD values when the probe was in physical contact with the tissue versus when it was not. The capacity of forward- and side-viewing M-mode OCT probes to produce high-quality B-mode images was compared by computing the percentages of the M-to-B-mode images that showed close contact between the probe and the luminal surface. Passively scanned M-to-B-mode images were qualitatively compared to B-mode images obtained by mechanical scanning OCT tethered capsule endomicroscopy (TCE) imaging devices. RESULTS The incorporation of M-mode OCT probes in these nonendoscopic GI devices safely and effectively enabled M-mode OCT imaging, facilitating real-time device placement guidance and contact sensing in vivo. Results showed that M-mode OCT contact sensing improved the variance of IPD measurements threefold and side-viewing probes increased M-to-B-mode image visibility by 10%. Images of the esophagus, stomach, and duodenum generated by the passively scanned probes and M-to-B-mode conversion were qualitatively superior to B-mode images obtained by mechanically scanning OCT TCE devices. CONCLUSION These results show that passive, single optical fiber OCT probes can be effectively utilized for nonendoscopic device placement guidance, device contact sensing, and two-dimensional morphologic imaging in the human GI tract in vivo. Due to their small size, lower cost, and reduced complexity, these M-mode OCT probes may provide an easier avenue for the incorporation of OCT functionality into endoscopic/nonendoscopic devices.
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Affiliation(s)
- David O Otuya
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Nicholas M Dechene
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Darina Poshtupaka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Seth Judson
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Camella J Carlson
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah K Zemlok
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Evan Sevieri
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Peter Choy
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rachel E Shore
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Alissa A Cirio
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Tyler W Rihm
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alexander A Krall
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Evangelia Gavgiotaki
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Jing Dong
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah L Silva
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Aaron Baillargeon
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Grace Baldwin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anna H Gao
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Zachary Jansa
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amilcar Barrios
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily Ryan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nitasha G M Bhat
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Indira Balmasheva
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anita Chung
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Catriona N Grant
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ara L Bablouzian
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Matthew Beatty
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Osman O Ahsen
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Hui Zheng
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Biostatistics, Boston, Massachusetts, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard-MIT Division of Health Sciences and Technology (HST), Boston, Massachusetts, USA
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14
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Monroy GL, Won J, Shi J, Hill MC, Porter RG, Novak MA, Hong W, Khampang P, Kerschner JE, Spillman DR, Boppart SA. Automated classification of otitis media with OCT: augmenting pediatric image datasets with gold-standard animal model data. BIOMEDICAL OPTICS EXPRESS 2022; 13:3601-3614. [PMID: 35781950 PMCID: PMC9208614 DOI: 10.1364/boe.453536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/28/2022] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
Otitis media (OM) is an extremely common disease that affects children worldwide. Optical coherence tomography (OCT) has emerged as a noninvasive diagnostic tool for OM, which can detect the presence and quantify the properties of middle ear fluid and biofilms. Here, the use of OCT data from the chinchilla, the gold-standard OM model for the human disease, is used to supplement a human image database to produce diagnostically relevant conclusions in a machine learning model. Statistical analysis shows the datatypes are compatible, with a blended-species model reaching ∼95% accuracy and F1 score, maintaining performance while additional human data is collected.
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Affiliation(s)
- Guillermo L. Monroy
- Beckman Institute for Advanced
Science and Technology, 405 N Mathews Ave, Urbana, IL
61801, USA
| | - Jungeun Won
- Beckman Institute for Advanced
Science and Technology, 405 N Mathews Ave, Urbana, IL
61801, USA
- Department of Bioengineering,
University of Illinois at Urbana-Champaign,
1406 W Green St, Urbana, IL 61801, USA
| | - Jindou Shi
- Beckman Institute for Advanced
Science and Technology, 405 N Mathews Ave, Urbana, IL
61801, USA
- Department of Electrical and Computer
Engineering, University of Illinois at
Urbana-Champaign, 306 N Wright St, Urbana, IL 61801,
USA
| | - Malcolm C. Hill
- Carle Foundation
Hospital, 611 W Park St., Urbana, IL 61801, USA
| | - Ryan G. Porter
- Carle Foundation
Hospital, 611 W Park St., Urbana, IL 61801, USA
- Carle Illinois College of Medicine,
University of Illinois at Urbana-Champaign,
506 S. Mathews Ave., Urbana, IL 61801, USA
| | - Michael A. Novak
- Carle Foundation
Hospital, 611 W Park St., Urbana, IL 61801, USA
- Carle Illinois College of Medicine,
University of Illinois at Urbana-Champaign,
506 S. Mathews Ave., Urbana, IL 61801, USA
| | - Wenzhou Hong
- Department of Otolaryngology and
Communication Sciences, Medical College of
Wisconsin, Milwaukee, WI 53226, USA
| | - Pawjai Khampang
- Department of Otolaryngology and
Communication Sciences, Medical College of
Wisconsin, Milwaukee, WI 53226, USA
| | - Joseph E. Kerschner
- Department of Otolaryngology and
Communication Sciences, Medical College of
Wisconsin, Milwaukee, WI 53226, USA
- Division of Otolaryngology and Pediatric
Otolaryngology, Medical College of
Wisconsin, Milwaukee, WI 53226, USA
| | - Darold R. Spillman
- Beckman Institute for Advanced
Science and Technology, 405 N Mathews Ave, Urbana, IL
61801, USA
| | - Stephen A. Boppart
- Beckman Institute for Advanced
Science and Technology, 405 N Mathews Ave, Urbana, IL
61801, USA
- Department of Bioengineering,
University of Illinois at Urbana-Champaign,
1406 W Green St, Urbana, IL 61801, USA
- Department of Electrical and Computer
Engineering, University of Illinois at
Urbana-Champaign, 306 N Wright St, Urbana, IL 61801,
USA
- Carle Illinois College of Medicine,
University of Illinois at Urbana-Champaign,
506 S. Mathews Ave., Urbana, IL 61801, USA
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15
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Assessing the Effect of Middle Ear Effusions on Wideband Acoustic Immittance Using Optical Coherence Tomography. Ear Hear 2021; 41:811-824. [PMID: 31634213 PMCID: PMC7165028 DOI: 10.1097/aud.0000000000000796] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Wideband acoustic immittance (WAI) noninvasively assesses middle ear function by measuring the sound conduction over a range of audible frequencies. Although several studies have shown the potential of WAI for detecting the presence of middle ear effusions (MEEs), determining the effects of MEE type and amount on WAI in vivo has been challenging due to the anatomical location of middle ear cavity. The purpose of this study is to correlate WAI measurements with physical characteristics of the middle ear and MEEs determined by optical coherence tomography (OCT), a noninvasive optical imaging technique.
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16
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Song G, Jelly ET, Chu KK, Kendall WY, Wax A. A review of low-cost and portable optical coherence tomography. PROGRESS IN BIOMEDICAL ENGINEERING (BRISTOL, ENGLAND) 2021; 3:032002. [PMID: 37645660 PMCID: PMC10465117 DOI: 10.1088/2516-1091/abfeb7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Optical coherence tomography (OCT) is a powerful optical imaging technique capable of visualizing the internal structure of biological tissues at near cellular resolution. For years, OCT has been regarded as the standard of care in ophthalmology, acting as an invaluable tool for the assessment of retinal pathology. However, the costly nature of most current commercial OCT systems has limited its general accessibility, especially in low-resource environments. It is therefore timely to review the development of low-cost OCT systems as a route for applying this technology to population-scale disease screening. Low-cost, portable and easy to use OCT systems will be essential to facilitate widespread use at point of care settings while ensuring that they offer the necessary imaging performances needed for clinical detection of retinal pathology. The development of low-cost OCT also offers the potential to enable application in fields outside ophthalmology by lowering the barrier to entry. In this paper, we review the current development and applications of low-cost, portable and handheld OCT in both translational and research settings. Design and cost-reduction techniques are described for general low-cost OCT systems, including considerations regarding spectrometer-based detection, scanning optics, system control, signal processing, and the role of 3D printing technology. Lastly, a review of clinical applications enabled by low-cost OCT is presented, along with a detailed discussion of current limitations and outlook.
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Affiliation(s)
- Ge Song
- Author to whom any correspondence should be addressed.
| | | | - Kengyeh K Chu
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States of America
| | - Wesley Y Kendall
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States of America
| | - Adam Wax
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States of America
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17
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Doppler Optical Coherence Tomography for Otology Applications: From Phantom Simulation to In Vivo Experiment. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In otology, visualization and vibratory analysis have been crucial to enhance the success of diagnosis and surgical operation. Optical coherence tomography (OCT) has been employed in otology to obtain morphological structure of tissues non-invasively, owing to the ability of measuring the entire region of tympanic membrane, which compensates the limitations of conventional methods. As a functional extension of OCT, Doppler OCT, which enables the measurement of the motion information with structural data of tissue, has been applied in otology. Over the years, Doppler OCT systems have been evolved in various forms to enhance the measuring sensitivity of phase difference. In this review, we provide representative algorithms of Doppler OCT and various applications in otology from preclinical analysis to clinical experiments and discuss future developments.
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18
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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: 8] [Impact Index Per Article: 2.7] [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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19
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Ali S, Gilani SBS, Shabbir J, Almulhim KS, Bugshan A, Farooq I. Optical coherence tomography's current clinical medical and dental applications: a review. F1000Res 2021; 10:310. [PMID: 33976868 PMCID: PMC8086034 DOI: 10.12688/f1000research.52031.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/20/2022] Open
Abstract
Optical coherence tomography (OCT) is a non-invasive investigative technique that is used to obtain high-resolution three-dimensional (3D) images of biological structures. This method is useful in diagnosing diseases of specific organs like the eye, where a direct biopsy cannot be conducted. Since its inception, significant advancements have been made in its technology. Apart from its initial application in ophthalmology for retinal imaging, substantial technological innovations in OCT brought by the research community have enabled its utilization beyond its original scope and allowed its application in many new clinical areas. This review presents a summary of the clinical applications of OCT in the field of medicine (ophthalmology, cardiology, otology, and dermatology) and dentistry (tissue imaging, detection of caries, analysis of dental polymer composite restorations, imaging of root canals, and diagnosis of oral cancer). In addition, potential advantages and disadvantages of OCT are also discussed.
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Affiliation(s)
- Saqib Ali
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saqlain Bin Syed Gilani
- Department of Oral Biology, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Juzer Shabbir
- Department of Operative Dentistry and Endodontics, Liaquat College of Medicine and Dentistry, Karachi, Pakistan
| | - Khalid S. Almulhim
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amr Bugshan
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Imran Farooq
- Faculty of Dentistry, University of Toronto, Toronto, ON, M5G 1G6, Canada
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20
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Pichichero ME. Can Machine Learning and AI Replace Otoscopy for Diagnosis of Otitis Media? Pediatrics 2021; 147:peds.2020-049584. [PMID: 33731368 DOI: 10.1542/peds.2020-049584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Michael E Pichichero
- Research Institute at Rochester General Hospital, Center for Infectious Diseases and Immunology, Rochester, New York; and Center for Immunology and Infectious Diseases, University of California, Davis, Davis, California
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21
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Utilization potential of intraluminal optical coherence tomography for the Eustachian tube. Sci Rep 2021; 11:6219. [PMID: 33737591 PMCID: PMC7973536 DOI: 10.1038/s41598-021-85634-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/02/2021] [Indexed: 12/17/2022] Open
Abstract
Imaging the Eustachian tube is challenging because of its complex anatomy and limited accessibility. This study fabricated a fiber-based optical coherence tomography (OCT) catheter and investigated its potential for assessing the Eustachian tube anatomy. A customized OCT system and an imaging catheter, termed the Eustachian OCT, were developed for visualizing the Eustachian tube. Three male swine cadaver heads were used to study OCT image acquisition and for subsequent histologic correlation. The imaging catheter was introduced through the nasopharyngeal opening and reached toward the middle ear. The OCT images were acquired from the superior to the nasopharyngeal opening before and after Eustachian tube balloon dilatation. The histological anatomy of the Eustachian tube was compared with corresponding OCT images, The new, Eustachian OCT catheter was successfully inserted in the tubal lumen without damage. Cross-sectional images of the tube were successfully obtained, and the margins of the anatomical structures including cartilage, mucosa lining, and fat could be successfully delineated. After balloon dilatation, the expansion of the cross-sectional area could be identified from the OCT images. Using the OCT technique to assess the Eustachian tube anatomy was shown to be feasible, and the fabricated OCT image catheter was determined to be suitable for Eustachian tube assessment.
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22
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Won J, Hong W, Khampang P, Spillman DR, Marshall S, Yan K, Porter RG, Novak MA, Kerschner JE, Boppart SA. Longitudinal optical coherence tomography to visualize the in vivo response of middle ear biofilms to antibiotic therapy. Sci Rep 2021; 11:5176. [PMID: 33664323 PMCID: PMC7933323 DOI: 10.1038/s41598-021-84543-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/15/2021] [Indexed: 01/31/2023] Open
Abstract
Studying the impact of antibiotic treatment on otitis media (OM), the leading cause of primary care office visits during childhood, is critical to develop appropriate treatment strategies. Tracking dynamic middle ear conditions during antibiotic treatment is not readily applicable in patients, due to the limited diagnostic techniques available to detect the smaller amount and variation of middle ear effusion (MEE) and middle ear bacterial biofilm, responsible for chronic and recurrent OM. To overcome these challenges, a handheld optical coherence tomography (OCT) system has been developed to monitor in vivo response of biofilms and MEEs in the OM-induced chinchilla model, the standard model for human OM. As a result, the formation of MEE as well as biofilm adherent to the tympanic membrane (TM) was longitudinally assessed as OM developed. Various types of MEEs and biofilms in the chinchilla model were identified, which showed comparable features as those in humans. Furthermore, the effect of antibiotics on the biofilm as well as the amount and type of MEEs was investigated with low-dose and high-dose treatment (ceftriaxone). The capability of OCT to non-invasively track and examine middle ear conditions is highly beneficial for therapeutic OM studies and will lead to improved management of OM in patients.
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Affiliation(s)
- Jungeun Won
- grid.35403.310000 0004 1936 9991Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL USA ,grid.35403.310000 0004 1936 9991Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Wenzhou Hong
- grid.30760.320000 0001 2111 8460Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI USA
| | - Pawjai Khampang
- grid.30760.320000 0001 2111 8460Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI USA
| | - Darold R. Spillman
- grid.35403.310000 0004 1936 9991Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Samuels Marshall
- grid.30760.320000 0001 2111 8460Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI USA
| | - Ke Yan
- grid.30760.320000 0001 2111 8460Section of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI USA
| | - Ryan G. Porter
- grid.413441.70000 0004 0476 3224Department of Otolaryngology, Carle Foundation Hospital, Urbana, IL USA ,grid.35403.310000 0004 1936 9991Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL USA
| | - Michael A. Novak
- grid.413441.70000 0004 0476 3224Department of Otolaryngology, Carle Foundation Hospital, Urbana, IL USA ,grid.35403.310000 0004 1936 9991Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL USA
| | - Joseph E. Kerschner
- grid.30760.320000 0001 2111 8460Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI USA ,grid.30760.320000 0001 2111 8460Division of Otolaryngology and Pediatric Otolaryngology, Medical College of Wisconsin, Milwaukee, WI USA
| | - Stephen A. Boppart
- grid.35403.310000 0004 1936 9991Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL USA ,grid.35403.310000 0004 1936 9991Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL USA ,grid.35403.310000 0004 1936 9991Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, IL USA ,grid.35403.310000 0004 1936 9991Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL USA
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Cheng Y, Chu Z, Wang RK. Robust three-dimensional registration on optical coherence tomography angiography for speckle reduction and visualization. Quant Imaging Med Surg 2021; 11:879-894. [PMID: 33654662 PMCID: PMC7829160 DOI: 10.21037/qims-20-751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/18/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND In the clinical applications of optical coherence tomography angiography (OCTA), the repeated scanning and averaging method can provide better contrast with reduced speckle noises in the final results, which are useful for visualizing and quantifying vascular components with high accuracy, reproducibility, and reliability. However, the inevitable patient motion presents a challenge to this method. The objective of this study is to meet this challenge by introducing a 3D registration method to register optical coherence tomography (OCT)/OCTA scans for precise volume averaging of multiple scans to improve the signal-to-noise ratio (SNR) and increase quantification accuracy. METHODS The proposed method utilized both rigid affine transformation and non-rigid B-spline transformation in which their parameters were optimized and calculated by the average stochastic gradient descent on OCT structural images. In addition, we also introduced a multi-level resolution approach to further improve the robustness and computational speed of our proposed method. The imaging performance was tested on in vivo imaging of human skin and eye and assessed by SNR, peak signal-to-noise ratio (PSNR) and normalized correlation coefficient (NCC). RESULTS Five subjects were enrolled in this study for obtaining in vivo images of skin and retina. The proposed registration and averaging method provided substantial improvements of the imaging performance in terms of vessel connectivity and signal to noise ratio. The increase of repeated volume numbers in the averaging improves all the metrics assessed, i.e., SNR, PSNR and NCC. An improvement of the SNR from 10 to 40 dB after 10 repeated volumetric averaging was achieved. CONCLUSIONS The proposed 3D registration and averaging method is effective in reducing speckle noises and suppressing motion artifacts, thereby improving SNR, PSNR and NCC metrics for final averaged images. It is expected that the proposed algorithm would be practically useful in better visualization and more reliable quantification of in vivo OCT and OCTA data, which would be beneficial to OCT clinical applications.
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Affiliation(s)
- Yuxuan Cheng
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Zhongdi Chu
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Ruikang K. Wang
- Department of Bioengineering, University of Washington, Seattle, WA, USA
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
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24
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Yao X, Teh BM, Li H, Hu Y, Huang J, Lv C, Bu S, Zheng M, Shen Y. Acellular Collagen Scaffold With Basic Fibroblast Growth Factor for Repair of Traumatic Tympanic Membrane Perforation in a Rat Model. Otolaryngol Head Neck Surg 2021; 164:381-390. [PMID: 32662734 DOI: 10.1177/0194599820938345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the efficacy of acellular collagen scaffold (ACS) in combination with basic fibroblast growth factor (bFGF) for the repair of traumatic tympanic membrane (TM) perforation in a rat model. STUDY DESIGN A prospective controlled animal study in a rat model of traumatic TM perforation. SETTING Tertiary medical center. SUBJECTS AND METHODS Sprague-Dawley rats (N = 84) with unilateral traumatic perforation of the right TMs were randomized to receive ACS, bFGF, ACS in combination with bFGF (ACS/bFGF), or nothing (spontaneous healing without any interventions as a control group). The healing outcomes were evaluated by otoscopy, optical coherence tomography, histology, and transmission electron microscopy at 1, 2, and 4 weeks postoperatively. The hearing outcomes were assessed with auditory brainstem response testing. RESULTS ACS/bFGF resulted in higher perforation closure rates at an earlier stage than spontaneous healing, ACS, and bFGF. Based on histology, optical coherence tomography, and transmission electron microscopy, a trilaminar structure and uniform thickness with mature, densely packed collagen fibers were seen in the ACS/bFGF group. Auditory brainstem response evaluation also showed that ACS/bFGF treatment promoted faster functional hearing recovery as compared with the control group. CONCLUSIONS ACS is an effective TM scaffold and a carrier for bFGF. ACS/bFGF improves the TM closure rate, results in better-reconstructed TMs, and improves hearing. ACS/bFGF serves as a potential substitute for TM perforations in clinical settings.
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Affiliation(s)
- Xu Yao
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Bing Mei Teh
- Department of Ear, Nose, and Throat-Head and Neck Surgery, Eastern Health, Box Hill, Australia
- Department of Otolaryngology-Head and Neck Surgery, Monash Health; Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - Huan Li
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Yi Hu
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Juntao Huang
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Cuiting Lv
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
| | - Shizhong Bu
- School of Medicine, Ningbo University, Ningbo, China
| | - Minghao Zheng
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Nedlands, Australia
| | - Yi Shen
- Department of Otolaryngology-Head and Neck Surgery, Ningbo Medical Center (Ningbo Lihuili Hospital), The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China
- School of Medicine, Ningbo University, Ningbo, China
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Saxby AJ, Jufas N, Kong JHK, Newey A, Pitman AG, Patel NP. Novel Radiologic Approaches for Cholesteatoma Detection: Implications for Endoscopic Ear Surgery. Otolaryngol Clin North Am 2020; 54:89-109. [PMID: 33153729 DOI: 10.1016/j.otc.2020.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Technological advancement in computed tomography (CT) and MRI has improved cholesteatoma detection rates considerably in the past decade. Accurately predicting disease location and extension is essential for staging, planning, and preoperative counseling, in particular in the newer approach of endoscopic ear surgery. Improved sensitivity and specificity of these radiological methods may allow the surgeon to confidently monitor patients, therefore avoiding unnecessary surgery. This article outlines recent advances in CT and MRI technology and advantages and disadvantages of the newer techniques. Emphasis on improving the feedback loop between the radiologist and surgeon will increase the accuracy of these new technologies.
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Affiliation(s)
- Alexander J Saxby
- Department of Otolaryngology-Head and Neck Surgery, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Sydney, Australia.
| | - Nicholas Jufas
- Department of Otolaryngology-Head and Neck Surgery, Royal North Shore Hospital, 1 Reserve Road, St. Leonards, NSW 2065, Sydney, Australia
| | - Jonathan H K Kong
- Department of Otolaryngology-Head and Neck Surgery, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Sydney, Australia
| | - Allison Newey
- Department of Radiology, Royal North Shore Hospital, 1 Reserve Road, St. Leonards, NSW 2065, Sydney, Australia
| | - Alexander G Pitman
- Department of Radiology, Northern Beaches Hospital, 105 Frenchs Forest Road W, Frenchs Forest, NSW 2086, Sydney, Australia
| | - Nirmal P Patel
- Department of Otolaryngology-Head and Neck Surgery, Royal North Shore Hospital, 1 Reserve Road, St. Leonards, NSW 2065, Sydney, Australia
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Optical coherence tomography: current and future clinical applications in otology. Curr Opin Otolaryngol Head Neck Surg 2020; 28:296-301. [PMID: 32833887 DOI: 10.1097/moo.0000000000000654] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This article reviews literature on the use of optical coherence tomography (OCT) in otology and provides the reader with a timely update on its current clinical and research applications. The discussion focuses on the principles of OCT, the use of the technology for the diagnosis of middle ear disease and for the delineation of in-vivo cochlear microarchitecture and function. RECENT FINDINGS Recent advances in OCT include the measurement of structural and vibratory properties of the tympanic membrane, ossicles and inner ear in healthy and diseased states. Accurate, noninvasive diagnosis of middle ear disease, such as otosclerosis and acute otitis media using OCT, has been validated in clinical studies, whereas inner ear OCT imaging remains at the preclinical stage. The development of recent microscopic, otoscopic and endoscopic systems to address clinical and research problems is reviewed. SUMMARY OCT is a real-time, noninvasive, nonionizing, point-of-care imaging modality capable of imaging ear structures in vivo. Although current clinical systems are mainly focused on middle ear imaging, OCT has also been shown to have the ability to identify inner ear disease, an exciting possibility that will become increasingly relevant with the advent of targeted inner ear therapies.
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Psota P, Tang H, Pooladvand K, Furlong C, Rosowski JJ, Cheng JT, Lédl V. Multiple angle digital holography for the shape measurement of the unpainted tympanic membrane. OPTICS EXPRESS 2020; 28:24614-24628. [PMID: 32907000 PMCID: PMC7470675 DOI: 10.1364/oe.398919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
The shape of the tympanic membrane (TM) plays an important role in sound transmission through the ear for hearing. Previously we developed a high-speed holographic system employing a tunable wavelength laser for rapid TM shape measurement. However, the tunable laser illumination was not sufficient to measure the shape of the unpainted TM due to the semi-transparency of the TM and short exposure time of the camera. This paper presents a new multiple angle illumination technique that allows us to use a higher power single wavelength laser to perform shape measurements on the unpainted TM. Accuracy of the new method is demonstrated by a measure of a step gauge provided by the National Institute of Standards and Technology. We successfully applied the new shape measurement method on a fresh postmortem human TM without any paint.
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Affiliation(s)
- Pavel Psota
- Faculty of Mechatronics, Informatics and Interdisciplinary Studies, Technical University of Liberec, Liberec 46117, Czech Republic
- TOPTEC, Institute of Plasma Physics of the Czech Academy of Sciences, Turnov 51101, Czech Republic
| | - Haimi Tang
- Center for Holographic Studies and Laser Micro-mechaTronics (CHSLT), Worcester, MA 01609, USA
- Mechanical Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609, USA
| | - Koohyar Pooladvand
- Center for Holographic Studies and Laser Micro-mechaTronics (CHSLT), Worcester, MA 01609, USA
- Mechanical Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609, USA
| | - Cosme Furlong
- Center for Holographic Studies and Laser Micro-mechaTronics (CHSLT), Worcester, MA 01609, USA
- Mechanical Engineering Department, Worcester Polytechnic Institute, Worcester, MA 01609, USA
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA 02114, USA
| | - John J. Rosowski
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA 02114, USA
| | - Jeffrey T. Cheng
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA 02114, USA
| | - Vít Lédl
- TOPTEC, Institute of Plasma Physics of the Czech Academy of Sciences, Turnov 51101, Czech Republic
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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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31
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Oh SJ, Lee IW, Wang SG, Kong SK, Kim HK, Goh EK. Extratympanic Observation of Middle and Inner Ear Structures in Rodents Using Optical Coherence Tomography. Clin Exp Otorhinolaryngol 2019; 13:106-112. [PMID: 31668054 PMCID: PMC7248603 DOI: 10.21053/ceo.2019.00766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/06/2019] [Indexed: 01/07/2023] Open
Abstract
Objectives This study aimed to investigate whether optical coherence tomography (OCT) provides useful information about the microstructures of the middle and inner ear via extratympanic approach and thereby could be utilized as an alternative diagnostic technology in ear imaging. Methods Five rats and mice were included, and the swept-source OCT system was applied to confirm the extent of visibility of the middle and inner ear and measure the length or thickness of the microstructures in the ear. The cochlea was subsequently dissected following OCT and histologically evaluated to compare with the OCT images. Results The middle ear microstructures such as ossicles, stapedial artery and oval window through the tympanic membrane with the OCT could be confirmed in both rats and mice. It was also possible to obtain the inner ear images such as each compartment of the cochlea in the mice, but the bone covering bulla needed to be removed to visualize the inner ear structures in the rats which had thicker bulla. The bony thickness covering the cochlea could be measured, which showed no significant differences between OCT and histologic image at all turns of cochlea. Conclusion OCT has been shown a promising technology to assess real-time middle and inner ear microstructures noninvasively with a high-resolution in the animal model. Therefore, OCT could be utilized to provide additional diagnostic information about the diseases of the middle and inner ear.
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Affiliation(s)
- Se-Joon Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Il-Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Seoul, Korea
| | - Soo-Geun Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | - Soo-Keun Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
| | | | - Eui-Kyung Goh
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea
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32
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Cai L, Stomackin G, Perez NM, Lin X, Jung TT, Dong W. Recovery from tympanic membrane perforation: Effects on membrane thickness, auditory thresholds, and middle ear transmission. Hear Res 2019; 384:107813. [PMID: 31655347 DOI: 10.1016/j.heares.2019.107813] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/20/2019] [Accepted: 10/09/2019] [Indexed: 01/22/2023]
Abstract
Sounds delivered to the ear move the tympanic membrane (TM), which drives the middle-ear (ME) ossicles and transfers the acoustic energy to the cochlea. Perforations of the TM result in hearing loss because of less efficient sound conduction through the ME. The patterns of TM motions, and thus ME sound transmission, vary with frequency and depend on many factors, including the TM thickness. In this study, we measured TM thickness, auditory brainstem responses (ABR), and ME transmission immediately following a controlled pars tensa perforation and after 4 weeks of spontaneous recovery in a gerbil model. It is found that after recovery, the hearing thresholds showed a sloping pattern across frequencies: almost back to normal levels at frequencies between 2 and 8 kHz, sloping loss in the low (<2 kHz) and mid-frequency (8-30 kHz) range, and little restoration at frequencies above 30 kHz. This pattern was confirmed by the measured ME pressure gains. The thickness of the healed TM did not return to normal but was 2-3 times thicker over a significant portion of the membrane. The increased thickness was not limited to the perforated area but expanded into intact regions adjacent to the perforation, which led to an increased thickness in general. Combined, these results suggest that TM thickness is an important factor in determining its vibration patterns and efficiency to transfer sounds to the ossicles and thus influencing ME sound transmission, especially for high-frequency sounds. The results provided both structural and functional observations to explain the conductive hearing loss seen in patients with abnormal TMs, e.g., caused by otitis media, spontaneously healed post-perforation, or repaired via tympanoplasty in the clinic.
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Affiliation(s)
- Lingling Cai
- VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; Department of Radiology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai, China
| | | | - Nicholas M Perez
- VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; School of Computer Science and Engineering, California State University San Bernardino, San Bernardino, CA, 92407, USA
| | - Xiaohui Lin
- VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA
| | - Timothy T Jung
- VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, 92350, USA
| | - Wei Dong
- VA Loma Linda Healthcare System, Loma Linda, CA, 92357, USA; Department of Otolaryngology - Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, 92350, USA.
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33
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Kim W, Kim S, Huang S, Oghalai JS, Applegate BE. Picometer scale vibrometry in the human middle ear using a surgical microscope based optical coherence tomography and vibrometry system. BIOMEDICAL OPTICS EXPRESS 2019; 10:4395-4410. [PMID: 31565497 PMCID: PMC6757470 DOI: 10.1364/boe.10.004395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 05/10/2023]
Abstract
We have developed a highly phase stable optical coherence tomography and vibrometry system that attaches directly to the accessory area of a surgical microscope common to both the otology clinic and operating room. Careful attention to minimizing sources of phase noise has enabled a system capable of measuring vibrations of the middle ear with a sensitivity of < 5 pm in an awake human patient. The system is shown to be capable of collecting a wide range of information on the morphology and function of the ear in live subjects, including frequency tuning curves below the hearing threshold, maps of tympanic membrane vibrational modes and thickness, and measures of distortion products due to the nonlinearities in the cochlear amplifier.
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Affiliation(s)
- Wihan Kim
- Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Sangmin Kim
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Shuning Huang
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - John S. Oghalai
- Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
| | - Brian E. Applegate
- Department of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles, CA 90033, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
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Burwood GWS, Fridberger A, Wang RK, Nuttall AL. Revealing the morphology and function of the cochlea and middle ear with optical coherence tomography. Quant Imaging Med Surg 2019; 9:858-881. [PMID: 31281781 PMCID: PMC6571188 DOI: 10.21037/qims.2019.05.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 05/09/2019] [Indexed: 01/17/2023]
Abstract
Optical coherence tomography (OCT) has revolutionized physiological studies of the hearing organ, the vibration and morphology of which can now be measured without opening the surrounding bone. In this review, we provide an overview of OCT as used in the otological research, describing advances and different techniques in vibrometry, angiography, and structural imaging.
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Affiliation(s)
- George W. S. Burwood
- Department of Otolaryngology, Oregon Hearing Research Center/HNS, Oregon Health & Science University, Portland, OR, USA
| | - Anders Fridberger
- Department of Otolaryngology, Oregon Hearing Research Center/HNS, Oregon Health & Science University, Portland, OR, USA
- Department of Clinical and Experimental Medicine, Section for Neurobiology, Linköping University, Linköping, Sweden
| | - Ruikang K. Wang
- Department of Bioengineering and Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Alfred L. Nuttall
- Department of Otolaryngology, Oregon Hearing Research Center/HNS, Oregon Health & Science University, Portland, OR, USA
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MacDougall D, Morrison L, Morrison C, Morris DP, Bance M, Adamson RBA. Optical Coherence Tomography Doppler Vibrometry Measurement of Stapes Vibration in Patients With Stapes Fixation and Normal Controls. Otol Neurotol 2019; 40:e349-e355. [DOI: 10.1097/mao.0000000000002193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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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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