Abstract
Cholesteatoma of the ear can lead to life-threatening complications and its only treatment is surgery. The smallest remnants of cholesteatoma can lead to recurrence of this disease. Therefore, the optical properties of this tissue are of high importance to identify and remove all cholesteatoma during therapy. In this paper, we determine the absorption coefficient µ a and scattering coefficient µ s ' of cholesteatoma and bone samples in the wavelength range of 250 nm to 800 nm obtained during five surgeries. These values are determined by high precision integrating sphere measurements in combination with an optimized inverse Monte Carlo simulation (iMCS). To conserve the optical behavior of living tissues, the optical spectroscopy measurements are performed immediately after tissue removal and preparation. It is shown that in the near-UV and visible spectrum clear differences exist between cholesteatoma and bone tissue. While µ a is decreasing homogeneously for cholesteatoma, it retains at the high level for bone in the region of 350 nm to 580 nm. Further, the results for the cholesteatoma measurements correspond to published healthy epidermis data. These differences in the optical parameters reveal the future possibility to detect and identify, automatically or semi-automatically, cholesteatoma tissue for active treatment decisions during image-guided surgery leading to a better surgical outcome.
Highlights
Cholesteatoma, due to its destructive growth can lead to life-threatening complications and its only treatment is surgery
The 28 cholesteatoma samples were varying in terms of thickness d and size r as described in Sec. 2.2 due to the occurrence in each individual patient
As the visible range is of high interest to the surgeon to carry out daily diagnostic and therapeutic interventions with or without microscopic and endoscopic support, this is the spectral range of interest in this study
Summary
Cholesteatoma, due to its destructive growth can lead to life-threatening complications and its only treatment is surgery. It requires a complete resection to avoid a recurrence. Cholesteatoma is defined by squamous epithelium in the middle ear spaces. Its further growth in the middle ear and into the adjacent structures leads to life-threatening complications. The destruction of the ossicles and cochlea can cause hearing loss and can lead to deafness. An erosion of the facial canal can lead to facial paralysis. Meningitis, intracranial abscesses and sinus vein thrombosis [1,2,3,4]. The objectives of surgical management of cholesteatoma include eradicating the disease while recovering or preserving the hearing. In cases of residual and recurrent cholesteatoma, a revision surgery is strictly needed
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