Real-Time Structure and Function Assessments of Human Ears using Optical Coherence Tomography

/Abstract Hearing loss in military personnel is commonly caused by noise- or blast-related damage to the auditory periphery (middle ear and cochlea) and/or the central system. Current clinical diagnostic strategies are lengthy and costly, and face challenges in pinpointing the damaged structures, and how these changes deteriorate our hearing. To improve the (differential) diagnosis of hearing problems, we propose to advance the utility of a novel, cutting-edge technology, optical coherence tomography (OCT), for its use in a clinical setting. OCT is an imaging technique that is in widespread use by ophthalmologists and optometrists to assess the condition of the eye as well as the optic nerve, and significant advancements have been made since OCT was introduced to the field of hearing research. We are among a few groups working on translating OCT applications in the auditory system from its current research setting into a clinically available diagnostic technique as an OCT-otoscope. After extensive development of software and hardware, our OCT-otoscope system provides high-resolution images, and measures motions of the middle- and inner-ear structures with sub-nanometer resolution in real-time, and at high speed from the intact middle ear and cochlea in vivo. Our overall objective is to optimize the performance of our recently built OCT-otoscope into a clinical diagnostic device for real-time structure and function assessments of human ears. The OCT-otoscope has a small enough diameter (2 mm) for insertion into the human ear canal to visualize the middle ear ossicles through the eardrum. It is capable of real-time structure and function assessments of human middle ears non- invasively. In this application, the specific purpose is to optimize and commercialize the OCT-otoscope for human applications and establish clinical standards that identify the reason and severity of conductive hearing loss (CHL). Our proposal includes three specific aims that can be pursued concurrently. Aim 1 entails optimization, where the system’s performance, efficiency, and overall functionality are improved for human application. Aim 2 will establish standards for visualization middle ear in real-time using human temporal bones. This will determine the most informative and accurate OCT-probe positions within the ear canal for data collection (both anatomy and function) that pinpoint the “cause-and-effect relationships” in cases of simulated CHL. Aim 3 will visualize, in real-time, the middle ear of human subjects to demonstrate the safety and efficacy of the system. Acquired data will further contribute to the standards needed for OCT-based diagnoses of CHL. This is a critical step for the interpretation of the results and setting up the standard for OCT application in otology and audiology. The outcome should improve diagnosis of hearing loss through cost-effect real-time imaging, leading to quicker and more accurate assessments, facilitate rehabilitation and protection strategies for hearing loss, and directly benefit for military personnel, veterans, and civilians. Project Number: 1I01RX005359-01A1 | Fiscal Year: 2026 | NIH Institute/Center: Veterans Affairs (VA) | Principal Investigator: Wei Dong | Institution: VETERANS HEALTH ADMINISTRATION, LONG BEACH, CA | Activity Code: I01 | Study Section: Sensory Systems & Communication Disorders[RRD3] View on NIH RePORTER: https://reporter.nih.gov/project-details/11107337