Trans-Eustachian tube endoscopes

 

At any given time, 1 in 50 people suffer from middle ear disease, and optimal diagnosis requires visual inspection. We propose a new, ultra-thin endoscope that can enable inspection non-invasively, entering through the patient’s nose and passing through the Eustachian tube to access the ear. This device has the potential to provide accurate diagnoses and eliminate the need for exploratory surgery for many patients suffering from middle ear disease.

 

 Research Members: Isuru Godage, Loris Fichera, Neal Dillion, Michael Sielbold, and Robert J Webster.

Middle ear disease is one of the most prevalent worldwide disorders (1 in 50 people suffer from it at any given time), and definitive diagnosis often requires cutting the eardrum for visual inspection through the ear canal (Fig. 1). We propose a new ultra-thin endoscope that passes through the patient’s nose and then through the eustachian tube to reach the middle ear. This ultra-thin endoscope will have pan and tilt degrees of freedom at its tip to facilitate comprehensive visual inspection of the middle ear for diagnosis and monitoring of the healing process after surgery. The overarching hypothesis of our research is that if ME visualization can be achieved without surgery, then the diagnosis and surveillance of ME disease would become much simpler, resulting in better patient outcomes and reducing the overall cost of care.

Fig. 2: Ultra-thin flexure needle tips showing controllable bending.

We will design and build the steerable endoscope illustrated in Fig. 3. It will consist of a flexible Nitinol tube equipped with a miniature steerable tip that contains a compact chip-tip camera. The output of the camera (Fig. 2b) will be connected to an external video console to offer real-time visual feedback during ME examination. The steerable tip will be articulated at the proximal end by the otolaryngologist using a hand-held interface similar to that of a traditional endoscope. The conceptual rendering of the ultra-thin chip tip camera with built-in illumination is shown in Fig. 3.

 

Fig. 1: The Eustachian tube highlighted on a CT scan of a patient

We propose to create an ultra-thin endoscope by combining a miniature camera with a new steerable tip design (Fig. 2). The chip-tip camera has a diameter of 1.4mm and is packaged with several optical fibers for illumination. The camera has a field of view of 90° and a resolution of 160,000 pixels (i.e. an order of magnitude higher resolution than similarly sized fiberscopes), with a speed of 30 frames per second.

 

Fig. 3: Artist’s rendering of the proposed  ultra-thin chip tip camera with built-in illumination

Publications

  1. L. Fichera, N. P. Dillon, D. Zhang, Isuru. S. Godage, M. A. Siebold, B. Hartley, J. Noble, P. T. Russell, R. F. Labadie, R. J. Webster III, “Through the Eustachian Tube and Beyond: A New Miniature Robotic Endoscope to See into the Middle Ear“, in IEEE Robotics and Automation Letters (RAL), 2(3), 2017, pp. 1488-1494.