Multiwavelength Fluorescence Otoscope for Video-Rate Chemical Imaging of Middle Ear Pathology

Abstract

A common motif in otolaryngology is the lack of certainty regarding diagnosis for middle ear conditions, resulting in many patients being overtreated under the worst-case assumption. Although pneumatic otoscopy and adjunctive tests offer additional information, white light otoscopy has been the main tool for diagnosis of external auditory canal and middle ear pathologies for over a century. In middle ear pathologies, the inability to avail high-resolution structural and/or molecular imaging is particularly glaring, leading to a complicated and erratic decision analysis. Here, we propose a novel multiwavelength fluorescence-based video-rate imaging strategy that combines readily available optical elements and software components to create a novel otoscopic device. This modified otoscope enables low-cost, detailed and objective diagnosis of common middle ear pathological conditions. Using the detection of congenital cholesteatoma as a specific example, we demonstrate the feasibility of fluorescence imaging to differentiate this proliferative lesion from uninvolved middle ear tissue based on the characteristic autofluorescence signals. Availability of real-time, wide-field chemical information should enable more complete removal of cholesteatoma, allowing for better hearing preservation and substantially reducing the well-documented risks, costs and psychological effects of repeated surgical procedures.

Comparison of traditional otoscope to iPhone otoscope in the pediatric ED

“…Prior studies have evaluated specialized equipment for improving TM visualization: otomicroscopes, video pneumatic otoscopes, acoustic reflectometers, optoelectronic holographic otoscopes, fiberoptic teleotoscopes, soundgenerating otoscopes, interferometric otoscopes, and multiwavelength fluorescence otoscopes [6][7][8][9]. This equipment is expensive, requires technical expertise, and is not readily available in the primary care clinic, ED, or home.…”

Reliable measurement of E. coli single cell fluorescence distribution using a standard microscope set-up

“…Furthermore, the presented method could be easily adapted to be used in other applications where the output is a fluorescent signal. These include immunofluorescence assays using fluorophore-conjugated antibodies to quantify gene expression in eukaryotic cells, and new diagnostic strategies such as the one presented in [ 21 ] where the measurement of the auto-fluorescence in a highly keratinized epithelium can address the analysis of a middle ear pathology.…”

Blood equivalent phantom vs whole human blood, a comparative study

“…Therefore, we ensure that our conclusions are valid for wide range of variability in investigated samples. Presented results may¯nd application in testing various optical detection methods in biology and medicine, such as other spectroscopic [41][42][43][44] as well as low-coherence methods. [45][46][47] In the case of not chemically-speci¯c methods, the phantoms have certain viability as a¯rst-trial physical model, as they are easier to handle and their parameters can be easily modi¯ed (ex.…”