Imaging guidance for cholesteatoma surgery using tissue autofluorescence

Stella Yang; Joyce Farrell; Shenglin Ye; Iram Ahmad; Tulio A. Valdez

doi:10.1117/1.JBO.28.6.066003

16 June 2023 Imaging guidance for cholesteatoma surgery using tissue autofluorescence

Stella Yang, Joyce Farrell, Shenglin Ye, Iram Ahmad, Tulio A. Valdez

Author Affiliations +

Journal of Biomedical Optics, Vol. 28, Issue 6, 066003 (June 2023). https://doi.org/10.1117/1.JBO.28.6.066003

Abstract

Significance

Cholesteatoma is an expansile destructive lesion of the middle ear and mastoid, which can result in significant complications by eroding adjacent bony structures. Currently, there is an inability to accurately distinguish cholesteatoma tissue margins from middle ear mucosa tissue, causing a high recidivism rate. Accurately differentiating cholesteatoma and mucosa will enable a more complete removal of the tissue.

Aim

Develop an imaging system to enhance the visibility of cholesteatoma tissue and margins during surgery.

Approach

Cholesteatoma and mucosa tissue samples were excised from the inner ear of patients and illuminated with 405, 450, and 520 nm narrowband lights. Measurements were made with a spectroradiometer equipped with a series of different longpass filters. Images were obtained using a red-green-blue (RGB) digital camera equipped with a long pass filter to block reflected light.

Results

Cholesteatoma tissue fluoresced under 405 and 450 nm illumination. Middle ear mucosa tissue did not fluoresce under the same illumination and measurement conditions. All measurements were negligible under 520 nm illumination conditions. All spectroradiometric measurements of cholesteatoma tissue fluorescence can be predicted by a linear combination of emissions from keratin and flavin adenine dinucleotide. We built a prototype of a fluorescence imaging system using a 495 nm longpass filter in combination with an RGB camera. The system was used to capture calibrated digital camera images of cholesteatoma and mucosa tissue samples. The results confirm that cholesteatoma emits light when it is illuminated with 405 and 450 nm, whereas mucosa tissue does not.

Conclusions

We prototyped an imaging system that is capable of measuring cholesteatoma tissue autofluorescence.

CC BY: © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

Citation Download Citation

Stella Yang, Joyce Farrell, Shenglin Ye, Iram Ahmad, and Tulio A. Valdez "Imaging guidance for cholesteatoma surgery using tissue autofluorescence," Journal of Biomedical Optics 28(6), 066003 (16 June 2023). https://doi.org/10.1117/1.JBO.28.6.066003

Received: 22 March 2023; Accepted: 1 June 2023; Published: 16 June 2023

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