Researchers at the Keck School of Medicine of USC have adapted optical coherence tomography (OCT)—a technology commonly used in eye care—to visualize fluid levels and microstructures in the human inner ear. In a proof-of-concept study involving 19 patients undergoing ear surgery, OCT successfully measured levels of endolymph, a fluid linked to conditions like Ménière’s disease and vestibular schwannoma. Higher endolymph levels correlated with greater hearing loss, offering a potential biomarker for diagnosis and treatment planning.
Unlike MRI, which lacks the resolution to detect subtle fluid imbalances, OCT provides fast, high-resolution 3D images using light waves. The technique allowed researchers to distinguish between healthy and diseased inner ears and could eventually help guide surgical decisions, monitor treatment effectiveness, and support the development of therapies like gene-based hair cell regeneration.
Currently, the tool is limited to use during surgery, where the mastoid bone is temporarily removed to access the cochlea. But the team, led by Dr. John Oghalai and Dr. Brian Applegate, is working to refine the technology for noninvasive use in awake patients. Their goal is to create a clinic-ready version that can diagnose hearing loss more accurately and quickly—potentially transforming care for millions affected by inner ear disorders.
The research builds on earlier work imaging cochlear activity in live animals and is supported by the NIH and USC’s Nemirovsky Engineering and Medicine Opportunity Prize. If successful, OCT could become a routine part of hearing evaluations, much like it revolutionized retinal imaging in ophthalmology.
Article from USC Keck: Innovative imaging tool could improve diagnosis and treatment of hearing loss
Abstract in Science Translational Medicine: Human inner ear fluid imbalance detected by optical coherence tomography correlates with hearing loss
