Human inner ear fluid imbalance detected by optical coherence tomography correlates with hearing loss

IF 14.6 1区 医学 Q1 CELL BIOLOGY
Wihan Kim, Dorothy W. Pan, Bong Jik Kim, Zihan Yang, Marcela Moran Mojica, Joni K. Doherty, Seiji B. Shibata, Brian E. Applegate, John S. Oghalai
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Abstract

Hearing loss and vertigo occur when there is an imbalance between the two inner ear fluids, endolymph and perilymph. The inner ear is a small delicate structure encased in dense bone deep in the base of the skull, making it challenging to image with high resolution. Because the fluid chambers are so small, there is no reliable way to measure their balance in a living patient to guide therapy. Here, we translated the technology of optical coherence tomography (OCT) for use in the human inner ear. Peering through the otic capsule bone during mastoid surgery, we imaged the lateral and posterior semicircular canals of patients with Ménière’s disease or vestibular schwannoma and measured the endolymph-to-perilymph ratio. Compared with normal controls, both patient groups demonstrated increased endolymph and reduced perilymph, a disorder termed endolymphatic hydrops. OCT imaging demonstrated good repeatability for measuring the endolymph-to-perilymph ratio. Our data indicate that increased endolymph-to-perilymph ratios correlated with the degree of hearing loss. Thus, small yet meaningful changes in inner ear fluid balance are detectable with this approach with better resolution than gadolinium-enhanced 3 Tesla magnetic resonance imaging, the current gold standard clinical imaging modality. Our findings support the feasibility of imaging the human inner ear during surgical procedures with OCT and demonstrate the ability to detect endolymphatic hydrops. Moreover, this technique permits the measurement of the fluid chambers within the inner ear in real time during surgical procedures with adequate sensitivity to guide the management of complex but common ear diseases.
光学相干断层扫描检测的人内耳液体不平衡与听力损失相关
当两种内耳液体,内淋巴和外淋巴不平衡时,就会出现听力损失和眩晕。内耳是一个小而精致的结构,包裹在头骨底部深处的致密骨骼中,这使得高分辨率成像具有挑战性。由于液体腔太小,没有可靠的方法来测量活着的病人的平衡,以指导治疗。在这里,我们将光学相干断层扫描(OCT)技术应用于人类内耳。在乳突手术期间,我们透过耳囊骨,对患有msamuni病或前庭神经鞘瘤的患者的外侧和后半规管进行了成像,并测量了内淋巴与外淋巴的比值。与正常对照相比,两组患者均表现出内淋巴增多和外淋巴减少,这是一种称为内淋巴水肿的疾病。OCT成像显示测量内淋巴与淋巴周围比值具有良好的重复性。我们的数据表明,内淋巴与外淋巴比值的增加与听力损失的程度相关。因此,使用这种方法可以检测到内耳液体平衡的微小但有意义的变化,其分辨率优于钆增强3特斯拉磁共振成像(目前的金标准临床成像方式)。我们的研究结果支持了在手术过程中用OCT成像人内耳的可行性,并证明了检测内淋巴积液的能力。此外,该技术允许在外科手术过程中实时测量内耳内的液体腔,具有足够的灵敏度,以指导复杂但常见的耳部疾病的处理。
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来源期刊
Science Translational Medicine
Science Translational Medicine CELL BIOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
26.70
自引率
1.20%
发文量
309
审稿时长
1.7 months
期刊介绍: Science Translational Medicine is an online journal that focuses on publishing research at the intersection of science, engineering, and medicine. The goal of the journal is to promote human health by providing a platform for researchers from various disciplines to communicate their latest advancements in biomedical, translational, and clinical research. The journal aims to address the slow translation of scientific knowledge into effective treatments and health measures. It publishes articles that fill the knowledge gaps between preclinical research and medical applications, with a focus on accelerating the translation of knowledge into new ways of preventing, diagnosing, and treating human diseases. The scope of Science Translational Medicine includes various areas such as cardiovascular disease, immunology/vaccines, metabolism/diabetes/obesity, neuroscience/neurology/psychiatry, cancer, infectious diseases, policy, behavior, bioengineering, chemical genomics/drug discovery, imaging, applied physical sciences, medical nanotechnology, drug delivery, biomarkers, gene therapy/regenerative medicine, toxicology and pharmacokinetics, data mining, cell culture, animal and human studies, medical informatics, and other interdisciplinary approaches to medicine. The target audience of the journal includes researchers and management in academia, government, and the biotechnology and pharmaceutical industries. It is also relevant to physician scientists, regulators, policy makers, investors, business developers, and funding agencies.
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