High-resolution imaging of the middle ear with optical coherence tomography: a feasibility study.

BACKGROUND Optical coherence tomography (OCT) is a new medical imaging technology that generates cross-sectional images of tissue microstructure with micron-scale resolution. Optical coherence tomography is analogous to ultrasound, measuring the intensity of infrared light rather than acoustical waves. OBJECTIVE To demonstrate the feasibility of using OCT for ultra-high-resolution imaging of the middle ear via ex vivo imaging studies of human tissue. DESIGN Images of the tympanic membrane and middle ear were acquired ex vivo, through the ear canal, without perforating the tympanic membrane. MATERIALS Four excised intact temporal bones and the auditory apparatus were harvested from cadavers and imaged fresh, without previous fixation. RESULTS The resulting images were compared with the gross sample and verified the ability of OCT to delineate relevant structures, such as the tympanic membrane and its sublayers, and the middle ear ossicles, nerves, and tendons at higher resolutions than possible with standard clinical imaging technologies. CONCLUSION The ability of OCT to produce high-resolution images of tissue structure, without contact and in real time, as well as its ability to be integrated with endoscopes, suggests that this technology could become a useful modality for the diagnosis and management of a range of clinical middle ear abnormalities.