J Korean Med Sci.  2015 Mar;30(3):328-335. 10.3346/jkms.2015.30.3.328.

Optical Coherence Tomography for the Diagnosis and Evaluation of Human Otitis Media

Affiliations
  • 1School of Electronics Engineering, Kyungpook National University, Daegu, Korea.
  • 2Department of Otorhinolaryngology-Head and Neck Surgery Daegu Veterans Hospital, Daegu, Korea.
  • 3School of Nano-Bioscience and Chemical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Korea.
  • 4Department of Otorhinolaryngology, Kyungpook National University College of Medicine, Daegu, Korea. jangjh@knu.ac.kr

Abstract

We report the application of optical coherence tomography (OCT) to the diagnosis and evaluation of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to visualizing the surface of the tympanic membrane (TM), OCT effectively reveals the depth-resolved microstructure below the TM with very high spatial resolution, with the potential advantage of its use for diagnosing different types of OM. We examined the use of 840-nm spectral domain-OCT (SD-OCT) clinically, using normal ears and ears with the adhesive and effusion types of OM. Specific features were identified in two-dimensional OCT images of abnormal TMs, compared to images of healthy TMs. Analysis of the A-scan (axial depth scan) identified unique patterns of constituents within the effusions. The OCT images could not only be used to construct a database for the diagnosis and classification of OM but OCT might also represent an upgrade over current otoscopy techniques.

Keyword

Tomography, Optical Coherence; Tympanic Membrane; Otitis Media; Ear, Middle; Clinical Study

MeSH Terms

Adult
Ear Canal/anatomy & histology
Eustachian Tube/physiology
Female
Humans
Male
Middle Aged
Otitis Media/classification/*diagnosis
Tomography, Optical Coherence/instrumentation/*methods
Tympanic Membrane/*physiology

Figure

  • Fig. 1 Schematic and photograph of the 840-nm SD-OCT system and handheld OCT probe. (A) Schematic of the 840-nm SD-OCT system; (B) Acquisition of TM images; (C) Photograph of the handheld OCT probe. OCT, optical coherence tomography; TM, tympanic membrane.

  • Fig. 2 Representative OCT images and data of normal TMs. (A, B) B-mode and oto-endoscope images and A-scan plots from two healthy human volunteers. OCT, optical coherence tomography; TM, tympanic membrane; EL, epidermal layer; FL, fibrous layer; ML, mucous layer.

  • Fig. 3 Comparison of images and A-scan images of (A) normal right and (B) abnormal left TMs. TM, tympanic membrane.

  • Fig. 4 Audiogram. (A) Hearing evaluation report graph. (B) Hearing evaluation report chart and pure tone average and speech audiometer and word recognition.

  • Fig. 5 Representative OCT image and data of TM perforation in chronic OM. OCT, optical coherence tomography; TM, tympanic membrane.

  • Fig. 6 Differentiation of retracted TM and OME. (A) OCT of a retracted TM showing an air-gap and middle-ear mucosa below the TM and A-scan plot of TM, air-gap, and mucosa below the TM. (B) OCT and A-scan plot of OME, showing the TM and a highly scattering effusion in direct contact with the inner surface of the TM. TM, tympanic membrane; OME, otitis media with effusion; OCT, optical coherence tomography.


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