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Sci Rep. 2018 Nov 27;8(1):17432. doi: 10.1038/s41598-018-35563-5.

Clinical Utility of Intraoperative Tympanomastoidectomy Assessment Using a Surgical Microscope Integrated with an Optical Coherence Tomography.

Author information

1
School of Electronics Engineering, College of IT Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea.
2
Department of Biomedical Engineering, College of Engineering, Kyungil University, 50, Gamasil-gil, Hayang-eup, Gyeongsan-si, Gyeongsangbuk-do, 38428, Republic of Korea.
3
Department of Otolaryngology, School of Medicine, Ajou University, 164 World cup-ro, Yeongtong-gu, Suwon, Gyeunggi-do, 16499, Republic of Korea.
4
Department of Otolaryngology, School of Medicine, Ajou University, 164 World cup-ro, Yeongtong-gu, Suwon, Gyeunggi-do, 16499, Republic of Korea. jhj@ajou.ac.kr.
5
School of Electronics Engineering, College of IT Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu, 41566, Republic of Korea. jeehk@knu.ac.kr.

Abstract

Significant technical and optical advances are required for intraoperative optical coherence tomography (OCT) to be utilized during otological surgeries. Integrating OCT with surgical microscopy makes it possible to evaluate soft tissue in real-time and at a high resolution. Herein, we describe an augmented-reality, intraoperative OCT/microscope system with an extended working distance of 280 mm, providing more space for surgical manipulation than conventional techniques. We initially performed ex vivo experiments to evaluate system performance. In addition, we validated the system by performing preliminary clinical assessments of tympanomastoidectomy outcomes in six patients with chronic otitis media. The system evaluated residual inflammation in the region-of-interest of the mastoid bone. Most importantly, the system intraoperatively revealed the connection between the graft and the remnant tympanic membrane. The extended working distance allows otological surgeons to evaluate the status of both the mastoid bone and tympanic membrane during manipulation, affording full intraoperative imaging.

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