Despite the great potential of phase-sensitive Optical Coherence Tomography (OCT) for clinical studies of the middle ear volumetric morphology and function, there were no instruments available that would provide these diagnostic capabilities for clinicians. The latest manuscript by Wihan Kim et al. addresses this issue, by presenting the design and application of an easy to use highly phase-stable OCT imaging system that functions as an accessory to the common surgical microscope, a backbone of the hearing clinics and otology operating rooms. Careful attention to minimizing sources of phase noise has enabled this system to measure vibrations of the middle ear with a sensitivity of <5 pm in an awake human patient, more than enough to fulfill the primary design motivation of developing a highly phase-stable system for vibrometry. This high sensitivity of the instrument was used to measure tuning curves in the human middle ear at the threshold for hearing, potentially facilitating the improved identification of middle ear pathologies, before standard hearing tests could detect them. Measurements of vibratory response across the entire field-of-view of the tympanic membrane produced maps of the vibrational mode structure, which likely change with various pathologies. Standard OCT volumetric imaging also provided useful diagnostic information on middle ear structures. In all, this instrument represents the potential paradigm shift in day to day operation of otology clinics and operating rooms by providing a wide variety of diagnostic information on the middle ear.
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