Endoscopic OCT laser theragnostics
microbial inflammation in the middle ear
Otitis media is one of the most common infectious and bacterial diseases. One form of chronic otitis media is cholesteatoma. It evades antibiotic therapy by, among other things, forming biofilms and, in its aggressive nature, often eats invasively and branching into the middle ear and skull bone. The only effective therapy is classical microsurgical ear surgery with the goal of complete removal of the entire inflammatory focus. To date, intraoperative ability to differentiate inflammatory from healthy tissue during resection is limited.
Aims and procedure
The aim of this joint project is to develop an endoscopic, minimally invasive procedure with access to the middle ear through the auditory canal in order to replace the invasive, risky open surgery by means of an innovative theragnostic methodology. The diagnostic part will be covered by dynamic optical coherence tomography (dOCT), for which image processing and image stabilization algorithms are being developed. The therapy will be performed by vaporization of the inflamed tissue with a green microchip laser and post-treatment with UV radiation. The laser with appropriate pulse rate and duration will be developed and the parameters for the treatment will be determined. The work will result in a demonstrator that will be tested in a clinical trial.
Innovation and prospects
Compared to the old procedure, the new treatment method would be much gentler, leave hearing intact with a lower recurrence rate, and require less follow-up care. The developed technologies will be further developed into medical devices and can be applied to other disease patterns in the future.
Remedial surgery for chronic otitis,