Emerging Use of Optical Coherence Tomography in Otolaryngology

In order for this technology to be useful in the average clinician’s hands, engineers will have to design a much smaller, user-friendly piece of equipment with an on/off button that will automatically gather the signal, calibrate itself, and give you a report and visual images for analysis, said Dr. Armstrong.

Physicians treating voice disorders will be interested in OCT because it provides information about the microstructural anatomy of the vocal fold mucosa, said Dr. Klein. To the surgeon and patient, every millimeter matters.

One of the promising things you can do with OCT is map out scars on the vocal cords, he continued. On the horizon, there are businesses trying to develop a permanent gelatinous material that can be injected into a stiff vocal cord so that it will regain its vibration. When this capability arrives, an instrument like OCT can help us to identify the size and location of a scar area, so that we can precisely inject the substance.

Some may think OCT is like ‘Star Wars’ and too far off into the future, said Dr. Armstrong. But the technology is here today and improving rapidly. OCT has great promise in how we, as otolaryngologists, will clinically manage our patients. It will allow us to plan, target, follow, and manage a disease in a more effective and noninvasive manner.

Interferometry

Interferometry is the science and technique of superposing two or more waves (i.e., putting one on top of the other), resulting in an interference fringe pattern. In a Michelson interferometer, a light beam is split into two beams, a reference and sampling beam. Light reflected from the reference mirror and sample, forms an interference fringe as the detector. If a low coherent broadband light source (i.e., light with multiple colors) is used, interference fringe is formed only when the light in the reference and sampling arms travel at the same distance.

References

1. Armstrong WB, Ridgway JM, Vokes DE, et al. Optical coherence tomography of laryngeal cancer. Laryngoscope 2006;116:1107-13.

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2. Ridgeway JM, Armstrong WB, Guo S, et al. In vivo optical coherence tomography of the human oral cavity and oropharynx. Arch Otolaryngol Head Neck Surg 2006;132:1074-81.

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3. Klein AM, Pierce MC, Zeitels SM, et al. Imaging the human vocal folds in vivo with optical coherence tomography: a preliminary experience. Ann Otol Rhinol Laryngol 2006;115(4):277-84.

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4. Armstrong WB, Ridgway JM, Vokes DE, et al. Optical coherence tomography of laryngeal cancer. Laryngoscope 2006;116:1107-13.

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5. Guo, S, Hutchison R, Jackson RP, et al. Office-based optical coherence tomographic imaging of human vocal cords. J Biomedical Optics 2006;11(3):030501 -1/3.

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6. Mahmood U, Ridgway J, Jacson R, et al. In vivo optical coherence tomography of the nasal mucosa. Am J Rhinol 2006;20:155-9.

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7. Klein AM, Pierce MC, Zeitels SM, et al. Imaging the human vocal folds in vivo with optical coherence tomography: a preliminary experience. Ann Otol Rhinol Laryngol 2006;115(4): 277-84.

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©2007 The Triological Society