Optical coherence tomography of the middle ear

光学相干断层扫描（OCT）是一种新兴的模态成像中耳。它通过完整的鼓膜将中耳结构及其对声音的反应成像。这项技术代表了传导性听力损失诊断的一个令人兴奋的新方向，由于现有成像技术的不足，迄今为止，传导性听力损失的诊断在很大程度上不得不“盲目”进行。作为第一个研究小组，以证明临床OCTimaging的整个中耳和中耳振动测量在体内，我们有很好的条件，以推进这项技术，并提出了一个多方面的研究计划，以改善和临床验证我们的原型成像系统。我们将重新设计我们的OCT系统，使之适合内窥镜的外形，增加新的对比机制，并努力提高图像质量。这些改进将利用OCT成像技术的许多新进展，包括合成孔径聚焦、压缩传感、偏振敏感OCT和基于方差的微血管造影，这些技术以前都没有在耳部使用过。我们在改进临床系统工程方面的努力将得到临床前OCT系统的补充，该系统专门设计用于测量人类颞骨，在临床方面，我们将在两个地点进行定量和定性的患者研究，以确定该技术在为传导性听力损失患者提供有用诊断信息方面的有效性。我们的合作者包括来自美国和加拿大的世界领先的中耳力学和疾病专家。在整个项目过程中，我们将与我们的知识转化合作伙伴Conavi Medical密切合作，将该设备推向监管批准并推向市场，临床研究和工程结果将为最终的设备设计和使用提供信息。

Optical coherence tomography (OCT) is an emerging modality for imaging the middle ear. Itallows middle ear structures and their response to sound to be imaged through the intacteardrum. This technology represents an exciting new direction in the diagnosis of conductivehearing loss, an area which to date has largely had to be done "blind" due to the inadequacyof available imaging technologies. As the first research group to demonstrate clinical OCTimaging of the whole middle ear and middle ear vibrometry in vivo, we are well placed toadvance this technology and have proposed a multi-faceted research plan to improve andclinically validate our prototype imaging system. We will be re-engineering our OCT systeminto an endoscopic form factor, adding new contrast mechanisms and working to improveimage quality. These improvements will harness many new advances in OCT imagingtechnology including synthetic aperture focusing, compressed sensing, polarization-sensitiveOCT and variance-based microangiography, none of which have been used before in the ear.Our efforts to improve the engineering in our clinical system will be complemented by theconstruction of a preclinical OCT system specifically designed for measurements on humantemporal bones, the most important model for pre-clinical validation of middle ear therapies.On the clinical side we will be pursuing both quantitative and qualitative patient research attwo sites to determine the technology's effectiveness in providing useful diagnosticinformation for patients suffering from conductive hearing loss. Our collaborators includeworld-leading experts in middle ear mechanics and disease from the US and Canada. Overthe entire course of the project we will work closely with our Knowledge Translation partner,Conavi Medical, to move the device towards regulatory approval and onto the market, withthe results of clinical research and engineering informing the ultimate device design and use.