Optical coherence tomography of the middle ear

Optical coherence tomography (OCT) is an emerging modality for imaging the middle ear. It allows middle ear structures and their response to sound to be imaged through the intact eardrum. This technology represents an exciting new direction in the diagnosis of conductive hearing loss, an area which to date has largely had to be done "blind" due to the inadequacy of available imaging technologies. As the first research group to demonstrate clinical OCT imaging of the whole middle ear and middle ear vibrometry in vivo, we are well placed to advance this technology and have proposed a multi-faceted research plan to improve and clinically validate our prototype imaging system. We will be re-engineering our OCT system into an endoscopic form factor, adding new contrast mechanisms and working to improve image quality. These improvements will harness many new advances in OCT imaging technology including synthetic aperture focusing, compressed sensing, polarization-sensitive OCT 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 the construction of a preclinical OCT system specifically designed for measurements on human temporal 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 at two sites to determine the technology's effectiveness in providing useful diagnostic information for patients suffering from conductive hearing loss. Our collaborators include world-leading experts in middle ear mechanics and disease from the US and Canada. Over the 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, with the results of clinical research and engineering informing the ultimate device design and use.