Dynamic optical coherence tomography as a new diagnostic tool for otitis media

Introduction The definitive therapy of therapy-refractory chronic otitis media mesotympanalis or epitympanalis (cholesteatoma) consists in the surgical resection of the inflammatory progress. Intraoperative diagnostics are limited to the visual impression of the surgeon. Supportive imaging modalities have so far been little researched and have not found their way into clinical application and are therefore of great relevance.

Methods In this study, optical coherence tomography with microscopic resolution (mOCT) is evaluated for its ability to differentiate between healthy and inflamed tissue. Despite its high resolution, differentiation of individual cells with mOCT is often impossible due to coherent noise that reduces contrast. We overcome this limitation by evaluating the intracellular motion caused by metabolic activity over time. This recent addition to OCT, called dynamic OCT, has established correlative measurements with histology at the current state-of-the art in OCT technology.

Results Images were taken from ex vivo samples of chronic otitis media and cholesteatoma using dOCT imaging with microscopic resolution. It could be shown that dOCT enables the representation of cellular and subcellular structures in the cross-sectional image, which cannot be differentiated or can only be differentiated to a limited extent in native OCT. By exploiting the time dependence of the interferometric signals of the OCT, we were able to demonstrate for the first time a new, marker-free contrast mechanism in otitis media, which is based on cellular metabolism.

Conclusions: To our knowledge, these are the first results for the diagnosis of otitis media by dOCT.

Publication History

Article published online:
24 May 2022