title: Optical coherence tomography of cholesteatoma.
abstract: OBJECTIVE
  To image cholesteatoma using optical coherence tomography (OCT) and correlate the results with clinical findings and conventional observations obtained using binocular microscopy and histology. OCT is a high-resolution optical imaging modality that generates cross-sectional images of turbid media, such as tissue with resolution approaching that of light microscopy. OCT relies on intrinsic differences in tissue optical properties for image contrast.
  
  
  METHODS
  In vivo prospective clinical study.
  
  
  METHODS
  University Medical Center.
  
  
  METHODS
  Patients with cholesteatoma undergoing otologic surgery.
  
  
  METHODS
  Using a commercial OCT imaging system, we obtained cross-sectional images (resolution, approximately 10 microm; depth penetration, approximately 1 mm) of cholesteatomas.
  
  
  METHODS
  Images are obtained by raster scanning a single mode fiber across the interior of the probe. The imaging probe is sterilized and inserted into the middle ear or mastoid under microscopic guidance, and still images of the middle ear or mastoid mucosa and cholesteatoma when present were obtained.
  
  
  RESULTS
  OCT images of cholesteatomas demonstrate differences in signal intensity, which are distinct from those of normal or inflamed middle ear/mastoid mucosa. Identification of keratin in cholesteatoma, even if very thin, distinguished it from inflamed mucosa.
  
  
  CONCLUSIONS
  This is the first study that systematically used OCT to image cholesteatoma during otologic surgery. Cholesteatomas can be distinguished from normal or inflamed adjacent mucosa.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, California 92868, USA. hdjalili@uci.edu
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Djalilian
authors.forename: Marc
authors.initials: M
authors.lastname: Rubinstein
authors.forename: Edward C
authors.initials: EC
authors.lastname: Wu
authors.forename: Kaveh
authors.initials: K
authors.lastname: Naemi
authors.forename: Shawn
authors.initials: S
authors.lastname: Zardouz
authors.forename: Koohyar
authors.initials: K
authors.lastname: Karimi
authors.forename: Brian J F
authors.initials: BJ
authors.lastname: Wong
mesh_terms: D019412:Anatomy, Cross-Sectional; D018424:Cholesteatoma, Middle Ear / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007633:Keratins / Q000378:metabolism; D008416:Mastoid / Q000473:pathology; D009092:Mucous Membrane / Q000473:pathology; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted; D041623:Tomography, Optical Coherence
chemical_list: D007633:Keratins