Application of Spectral Domain Optical Coherence Tomography To Guide Cochlear Implant Electrode Array

Area of Science:

• Biomedical Engineering
• Otolaryngology
• Medical Imaging

Background:

• Cochlear implant electrode array (EA) insertion is currently a blind procedure relying on tactile feedback.
• Surgical trauma during cochlear implantation can lead to poor speech performance and loss of residual hearing.
• Optical coherence tomography (OCT) offers high-resolution, non-invasive real-time imaging, unlike CT and MRI.

Purpose of the Study:

• To develop and evaluate a custom spectral domain optical coherence tomography (SD-OCT) platform for real-time surgical guidance.
• To assess the potential of SD-OCT in visualizing cochlear microanatomy and guiding EA insertion.
• To reduce cochlear implant trauma and improve surgical outcomes.

Main Methods:

• A custom-built SD-OCT system was utilized to image cochlear microanatomy in mice and human cadaveric temporal bones.
• The SD-OCT system was employed to guide a mock EA in real-time through the round window in human cadaveric temporal bones.
• Sequential B-scans were used for navigation during EA advancement.

Main Results:

• High-resolution (< 5.0 μm) images of cochlear microanatomy were acquired with high sensitivity (∼104 dB).
• Real-time OCT B-scans reliably guided EA placement through the scala tympani in cadaveric temporal bones.
• The custom system enabled visualization critical for navigating the cochlea.

Conclusions:

• The custom SD-OCT platform provides high-resolution, real-time visualization of cochlear microanatomy.
• This technology can serve as a surgical image guidance tool for cochlear implant EA insertion.
• SD-OCT has the potential to minimize EA trauma and advance understanding of cochlear pathophysiology.