Quantification of the healthy and pathological tympanic membrane with a hand-held optical coherence tomography (HHOCT) device

Point-of-care depth resolved 3D imaging of the tympanic membrane and middle ear with OCT, combined with quantitative image analysis, could improve the diagnosis and management of patients in the clinical setting. We imaged the TMs and MEs of 55 patients in a neurotology clinic, using a custom-built hand-held OCT (HHOCT) device. Patients with a diagnosis of TM retraction pockets, perforations, cholesteatomas, and postoperative states were included in this study. Healthy volunteers were also imaged to provide a baseline for quantitative metrics. Images were post processed to perform segmentation of the TM and create thickness maps of the TM, derive mean TM thickness values, and conduct ear symmetry analysis. The normal mean TM thickness was found to be significantly different from every other condition explored. Ear symmetry of healthy subjects was found to be 80% between left and right ears. Quantitative metrics derived from OCT images can be used to characterize TM pathologies and potentially aid in diagnosis and management.