Assessment of middle ear structure and function with optical coherence tomography

BackgroundCurrent 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.ObjectiveAdapt 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 MethodsSD-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.ResultsThe 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 SignificanceWe 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.

Automated summary

In this study, a commercial SD-OCT was used to evaluate the anatomy and sound-induced vibrations of the middle ear in humans. The results showed that SD-OCT technology provides high-resolution 3D images of the tympanic membrane and ossicles, as well as measurements of middle ear sound transmission. Therefore, SD-OCT has the potential to revolutionize the point-of-care assessment of middle ear disruptions leading to CHL.