Optical coherence tomography of the tympanic membrane and middle ear: clinical applications.

PURPOSE OF REVIEW: Optical coherence tomography (OCT) is a noninvasive optical imaging technique to image soft tissue and thin bony structures with high resolution, approaching that of histology. This review summarizes recent progress in the clinical application of OCT for tympanic membrane and middle ear disease. RECENT FINDINGS: Recent reports from clinical trials show that OCT is having a meaningful impact on the diagnosis of fluid in the middle ear. In parallel with this, numerous groups are obtaining previously unattainable normative data in vivo on human middle ear structures. OCT is also starting to be used for functional assessments of the middle ear in the clinical setting by detecting sound and pressure-evoked motion. SUMMARY: OCT allows real-time noninvasive radiation-free structural and functional imaging of the tympanic membrane and middle ear at the point of care. As artificial intelligence becomes more commonplace in medicine, it is likely that OCT will become a key technology for the otolaryngologist. The data provided by OCT can be used to train machine learning algorithms for the segmentation of ear structures, which will ultimately support the automated diagnosis of ear disease. This will also aid in objectively tracking disease progression over time. Thus, OCT presents much promise for our field by revolutionizing office-based otological diagnostics.