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2 March 2010An optical coherence tomography study for imaging the round window niche and the promontorium tympani
An optical coherence tomography study for imaging the round window niche and the promontorium tympani
Tympanosclerosis may involve the tympanic membrane, the ossicles, and the oval and round window niche,
respectively. The surgical treatment of the obliterated oval window niche is most challenging. Beside stapesplasty,
vibroplasty coupling the floating mass transducer (FMT) onto the round window niche and into a new, so-called third
window is indicated. In the latter situation, drilling a hole into the promontorium is necessary to couple the FMT close to
the membranous endosteum. Damage of the membranous inner ear must be avoided. The question was whether OCT is
useful to identify the endosteum and to provide microanatomical information of the round window niche. OCT was
carried out on human temporal bone preparations, in which a third window was drilled leaving the membranous labyrinth
and the fluid-filled inner ear intact and the overhang of the round window niche was removed. An especially equipped
operating microscope with integrated OCT prototype (spectral-domain-OCT) was used. The OCT images and 3D
reconstructions demonstrate the usefulness of OCT to measure the drilling cavity, to visualize the inner ear structures,
and to obtain microanatomical information of the round and oval window niche. These findings may have an impact on
stapes surgery, on cochlea implantation, and on vibroplasty coupling the FMT onto the round and third window. OCTguided
drilling allows for more precise identification of the intact inner ear.
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T. Just, E. Lankenau, G. Hüttmann, H. W. Pau, "An optical coherence tomography study for imaging the round window niche and the promontorium tympani," Proc. SPIE 7548, Photonic Therapeutics and Diagnostics VI, 754833 (2 March 2010); https://doi.org/10.1117/12.848384