Use of optical coherence tomography otoscopy to overcome cerumen and other view obstructions during ear examination and assessment

Abstract

Childhood ear infections are highly prevalent and diagnosed with the otoscope, a simple tool that illuminates and magnifies the eardrum to subjectively assess color, translucency and presence of any middle ear fluid. Frequently, however, this view is obstructed by cerumen, complicating clinician assessment and appropriate and effective management. An optical coherence tomography (OCT)‐otoscope capable of capturing both depth‐resolved OCT images and digital color surface images was used to compare OCT against otoscopy for imageability and readability despite cerumen obstruction. Image data were collected from 26 human subjects and read by 12 blinded clinicians and 5 blinded OCT experts. An average of 64.6% of otoscopy views were obstructed. For cases with >75% otoscopy view obstruction, OCT imageability was 84.6%, while otoscopy imageability was 37.5%, excluding complete obstruction cases. OCT‐otoscopy is a promising technology to improve practical middle ear assessment despite the presence of obstructions that frequently render current diagnostic assessments ineffective.