Abstract
Imaging the Eustachian tube is challenging because of its complex anatomy and limited accessibility. This study fabricated a fiber-based optical coherence tomography (OCT) catheter and investigated its potential for assessing the Eustachian tube anatomy. A customized OCT system and an imaging catheter, termed the Eustachian OCT, were developed for visualizing the Eustachian tube. Three male swine cadaver heads were used to study OCT image acquisition and for subsequent histologic correlation. The imaging catheter was introduced through the nasopharyngeal opening and reached toward the middle ear. The OCT images were acquired from the superior to the nasopharyngeal opening before and after Eustachian tube balloon dilatation. The histological anatomy of the Eustachian tube was compared with corresponding OCT images, The new, Eustachian OCT catheter was successfully inserted in the tubal lumen without damage. Cross-sectional images of the tube were successfully obtained, and the margins of the anatomical structures including cartilage, mucosa lining, and fat could be successfully delineated. After balloon dilatation, the expansion of the cross-sectional area could be identified from the OCT images. Using the OCT technique to assess the Eustachian tube anatomy was shown to be feasible, and the fabricated OCT image catheter was determined to be suitable for Eustachian tube assessment.
Highlights
Imaging the Eustachian tube is challenging because of its complex anatomy and limited accessibility
The Eustachian optical coherence tomography (OCT) catheter was successfully introduced into the Eustachian tube without trauma through the nasopharyngeal opening
The results can be summarized as follows: (1) The OCT catheter was successfully introduced through the nasopharyngeal opening of the Eustachian tube without mucosal damage, (2) real-time OCT images could be acquired and the major structures of the Eustachian tube could be identified in the OCT images, and (3) the effect of the Eustachian tube balloon dilatation could be objectively measured with the OCT images
Summary
Imaging the Eustachian tube is challenging because of its complex anatomy and limited accessibility. This study fabricated a fiber-based optical coherence tomography (OCT) catheter and investigated its potential for assessing the Eustachian tube anatomy. The imaging catheter was introduced through the nasopharyngeal opening and reached toward the middle ear. Using the OCT technique to assess the Eustachian tube anatomy was shown to be feasible, and the fabricated OCT image catheter was determined to be suitable for Eustachian tube assessment. Optical coherence tomography (OCT) is a novel, non-invasive imaging technique that can provide realtime images with a microscopic resolution of 10–20 μm. It has been widely used in the ophthalmology field[9,10], Scientific Reports | (2021) 11:6219. An OCT system designed for the esophagus is too large for the Eustachian tube, and a coronary OCT system requires a guidewire for OCT placement, it does not provide images near the tip of the OCT catheter, which could make procedures in the Eustachian tube difficult
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