Digital video otoscope is an indispensable tool in otology that allows inspection of the external auditory canal and tympanic membrane. However, existing solutions have limitations in the diagnosis of various ear diseases and portability. Here, we propose a mobile, deep learning-assisted otoscope for low-resource settings. Our deep learning architecture was trained on clinical data to identify and classify various ear diseases. To evaluate our platform, we compared its performance with the device used in the hospital practice. Our preliminary results demonstrated high diagnostic accuracy indicating a strong potential to become a viable screening solution in low-resource, non-specialist settings.
Significant technical and optical advancements are required for intraoperative optical coherence tomography (OCT) to perform boundless surgical applications in otology, since the translation of OCT for surgical-microscope facilitates the simultaneous OCT and microscopic visualization of soft tissue structures of the surgical region with a high-resolution in real-time. Herein, we developed an augmented-reality intrasurgical OCT microscope system with an extended 280 mm working distance, which simply provides a sufficient space for the manipulation during surgeries compared to conventional techniques. Ex vivo experiments were initially performed to evaluate the enhanced system performances and secondly, the developed system was well-utilized to clinically assess the preliminary findings of tympanomastoidectomy in six patients with chronic otitis media. The OCT system evaluated the residual inflammation of region of interest in the mastoid bone and most importantly OCT was sufficiently useful for visualizing the connection between the graft and remnant tympanic membrane intraoperatively. Use of this extended-working distance OCT integrated surgical-microscope enables the surgeons to precisely define the aforementioned surgical requirements, while performing intraoperative imaging over the complete range.
The aim of this study was to analyze the effectiveness of decalcification using ethylenediaminetetraacetic acid (EDTA) as an optical clearing method to enhance the depth visibility of internal soft tissues of cochlea. Ex vivo mouse and guinea pig cochlea samples were soaked in EDTA solutions for decalcification, and swept source optical coherence tomography (OCT) was used as imaging modality to monitor the decalcified samples consecutively. The monitored noninvasive cross-sectional images showed that the mouse and guinea pig cochlea samples had to be decalcified for subsequent 7 and 14 days, respectively, to obtain the optimal optical clearing results. Using this method, difficulties in imaging of internal cochlea microstructures of mice could be evaded. The obtained results verified that the depth visibility of the decalcified ex vivo samples was enhanced.
Optical coherence tomography (OCT) has advanced significantly over the past two decades and is currently used extensively to monitor the internal structures of organs, particularly in ophthalmology and dermatology. We used ethylenediamine tetra-acetic acid (EDTA) to decalcify the bony walls of the cochlea and investigated the inner structures by deep penetration of light into the cochlear tissue using OCT on a guinea pig model of endolymphatic hydrops (EH), induced by surgical obliteration of the endolymphatic duct. The structural and functional changes associated with EH were identified using OCT and auditory brainstem response tests, respectively. We also evaluated structural alterations in the cochlea using three-dimensional reconstruction of the OCT images, which clearly showed physical changes in the cochlear structures. Furthermore, we found significant anatomical variations in the EH model and conducted graphical analysis by strial atrophy for comparison. The physical changes included damage to and flattening of the organ of Corti—evidence of Reissner’s membrane distention—and thinning of the lateral wall. These results indicate that observation of EDTA-decalcified cochlea using OCT is significant in examination of gradual changes in the cochlear structures that are otherwise not depicted by hematoxylin and eosin staining.
We report the application of Optical Coherence Tomography (OCT) to various types of human cases of otitis media (OM). Whereas conventional diagnostic modalities for OM, including standard and pneumatic otoscopy, are limited to
visualizing the surface information of the tympanic membrane (TM), OCT is able to effectively reveal the depth-resolved microstructural below the TM with a very high spatial resolution. With the potential advantage of using OCT
for diagnosing different types of OM, we examined in-vivo the use of 840 nm wavelength, and OCT spectral domain OCT (SDOCT) techniques, in several human cases including normal ears, and ears with adhesive and effusion types of OM. Peculiar positions were identified in two-dimensional OCT images of abnormal TMs compared to images of a
normal TM. Analysis of A-scan (axial depth-scans) data from these positions could successfully identify unique patterns for different constituents within effusions. These OCT images may not only be used for constructing a database for the
diagnosis and classification of OM, but they may also demonstrate the feasibility and advantages for upgrading the
current otoscopy techniques.
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