Imaging the human tympanic membrane using optical coherence tomography in vivo.

OBJECTIVE Optical coherence tomography (OCT) is a diagnostic imaging modality that combines low coherence light with interferometry to produce high-resolution cross-sectional images of living tissues. Using this technology, we have imaged in vivo the human tympanic membrane (TM) in the office clinic setting and characterized TM microstructure in normal and pathologic conditions. STUDY DESIGN Prospective clinical trial. MATERIALS AND METHODS The normal and diseased TMs in 10 adult subjects were examined. Each subject underwent direct microscopic examination before OCT imaging to provide visual coregistration of associated subsites including the anulus fibrosus, pars tensa, pars flaccida, and umbo. The probe from the imaging system (1,310-nm central wavelength, 15-microm coherence length, Niris; Imalux, Cleveland, OH, USA) was introduced into the ear canal to obtain lateral cross-sectional images. RESULTS Systematic imaging of the TM was performed with characterization of the epithelial and collagenous layers. The overall TM thickness was clearly demonstrated and quantified. CONCLUSION The ability to noninvasively study middle ear microstructures in vivo is essential in the treatment of diseases of the ear. OCT may provide the otologist/neurotologist with the ability to 1) image pathology such as cholesteatoma, dimeric TMs, and chronic otitis media; 2) gauge the response to pharmacological therapy; and 3) monitor postsurgical changes after tympanoplasty and other procedures. OCT may provide a means to optimize the diagnosis and management of patients with middle ear disease.