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Proceedings Paper

Comparison of high-resolution microendoscope images and histopathological sections in ex vivo middle ear cholesteatomas and surrounding tissue
Author(s): James Bradley; Lauren Levy; Rebecca Richards-Kortum; Andrew G. Sikora; Eric Smouha
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Paper Abstract

Objective: To investigate the concordance between optical images obtained with high-resolution microendoscopy (HRME) and conventional histopathology for ex vivo cholesteatoma specimens and surrounding middle ear epithelium. Methods: After resection of cholesteatoma and surrounding middle ear epithelium from surgical patients, tissues were stained with a contrast agent, proflavine, and the HRME fiberoptic scope was placed directly on each tissue specimen. 4- 10 short movie clips were recorded for both the cholesteatoma and surrounding middle ear epithelium specimens. The imaged areas were sent for standard histopathology, and the stained specimens were correlated with the HRME images. IRB approval was obtained, and each patient was consented for the study. Results: Ten cholesteatoma specimens and 9 middle ear specimens were collected from 10 patients. In each case, cholesteatoma was easily discriminated from normal middle ear epithelium by its hyperfluorescence and loss of cellular detail. Qualitative analysis for concordance between HRME images and histological images from the same surgical specimen yielded a strong correlation between imaging modalities. Conclusions: Keratinizing cholesteatoma and surrounding middle ear epithelium have distinct imaging characteristics. Loss of cellular detail and hyperfluorescence with proflavine are the hallmark characteristics of cholesteatoma which allow for differentiation from normal middle ear epithelium. Real-time optical imaging can potentially improve the results of otologic surgery by allowing for extirpation of cholesteatomas while eliminating residual disease. We anticipate performing an in vivo study to test this hypothesis.

Paper Details

Date Published: 8 March 2013
PDF: 6 pages
Proc. SPIE 8565, Photonic Therapeutics and Diagnostics IX, 85651W (8 March 2013); doi: 10.1117/12.2010230
Show Author Affiliations
James Bradley, Mount Sinai School of Medicine (United States)
Lauren Levy, Mount Sinai School of Medicine (United States)
Rebecca Richards-Kortum, Rice Univ. (United States)
Andrew G. Sikora, Mount Sinai School of Medicine (United States)
Eric Smouha, Mount Sinai School of Medicine (United States)

Published in SPIE Proceedings Vol. 8565:
Photonic Therapeutics and Diagnostics IX
Andreas Mandelis; Brian Jet-Fei Wong; Anita Mahadevan-Jansen; Henry Hirschberg M.D.; Hyun Wook Kang; Nikiforos Kollias; Melissa J. Suter; Kenton W. Gregory M.D.; Guillermo J. Tearney M.D.; Stephen Lam; Bernard Choi; Steen J. Madsen; Bodo E. Knudsen M.D.; E. Duco Jansen; Justus F. Ilgner M.D.; Haishan Zeng; Matthew Brenner; Laura Marcu, Editor(s)

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