Background:Otoscopy examination can be challenging.Traditional teaching uses still image illustrations.Newer attempts use video samples to simulate the otoscopy exam which is a dynamic process.Aims/Objective:To assess...Background:Otoscopy examination can be challenging.Traditional teaching uses still image illustrations.Newer attempts use video samples to simulate the otoscopy exam which is a dynamic process.Aims/Objective:To assess whether recorded otoscopy videos from a smartphone adaptable otoscope can be used to develop a video-based otoscopy quiz which may be used for instructing and familiarizing participants to normal anatomy and pathologic ear conditions.To use this quiz to assess current pediatric residents’competency of common otoscopy diagnosis.Method and materials:This study was conducted in 2018.Video samples of ear pathology were collected at the Albany Medical Center using a smartphone adaptable otoscope-Cellscope.The videos were used to create a video otoscopy quiz(VOQ)without clinical vignettes.45 pediatric residents from 3 academic institutions were evaluated with the quiz.Results:The weighted mean for the VOQ was 66.90%(95%CI 58.89%-68.42%).The breakdown by questions are:myringosclerosis 72.88%,retraction pocket 80.65%,cholesteatoma 42.22%,hemotympanum 75.04%,tympanic membrane perforation 79.62%,cerumen impaction 95.46%,otitis externa 52.54%,otitis media with effusion 63.30%,acute otitis media 75.55%,normal ear 36.39%.Conclusion:We found that videos of otoscopy exams can be obtained with a smartphone adaptable otoscope and validated to develop a video-based quiz,which may be used to supplement otoscopic instruction.Following our testing process,we found pediatric residents are relatively well equipped to identify ear pathology on VOQ.展开更多
Middle and outer ear diseases are common otological diseases worldwide.Otoscopy and otoendoscopy exami-nations are essential first steps in the evaluation of patients with otological diseases.Misdiagnosis often occurs...Middle and outer ear diseases are common otological diseases worldwide.Otoscopy and otoendoscopy exami-nations are essential first steps in the evaluation of patients with otological diseases.Misdiagnosis often occurs when the doctor lacks experience in interpreting the results of otoscopy or otoendoscopy,leading to delays in treatment or complications.Using deep learning to process otoscopy images and developing otoscopic artificial-intelligence-based decision-making systems will become a significant trend in the future.However,the uneven quality of otoscopy images is among the major obstacles to development of such artificial intelligence systems,and no standardized process for data acquisition,and annotation of otoscopy images in intelligent medicine has yet been fully established.The standards for data storage and data management are unified with those of other specialties and are introduced in detail here.This expert recommendation criterion improved and standardized the collection and annotation procedures for otoscopy images and fills the current gap in otologic intelligent medicine;it would thus lay a solid foundation for the standardized collection,storage,and annotation of oto-scopy images and the application of training algorithms,and promote the development of automatic diagnosis and treatment for otological diseases.The full text introduced image collection(including patient preparation,equipment standards,and image storage),image annotation standards,and quality control.展开更多
Gout is the most common cause of monoarthritis in men occurring classically in the great toe and the knee.Extra-articular gout manifestations are rare.Only a few cases of head and neck urate crystals deposits have bee...Gout is the most common cause of monoarthritis in men occurring classically in the great toe and the knee.Extra-articular gout manifestations are rare.Only a few cases of head and neck urate crystals deposits have been described in the literature.Precipitations in the middle ear cause conductive hearing loss with common otoscopic anomalies and difficult imaging diagnosis.We report a case of a healthy 58-years-old man with a middle ear urate deposit causing a progressive hearing loss as the very first symptom of gout.The nature of the deposit was unsure on computer tomography(CT)due to atypical density.The final diagnosis was revealed after surgical procedure and histologic examination.A review of the literature is also presented.Seven cases of middle ear urate deposit as the first symptom of gout were found and compared.Progressive conductive hearing loss in middle-aged patients with abnormal otoscopy and middle ear atypical density mass on CT scan must lead to a minimal surgical procedure with a histologic examination to exclude urate crystals deposits.展开更多
<strong>Aim:</strong> Chronic otitis media (COM) is chronic muco purulent discharge through a perforated tympanic membrane. Theossicular chain damage is found in both mucosal and squamosal types of COM. We...<strong>Aim:</strong> Chronic otitis media (COM) is chronic muco purulent discharge through a perforated tympanic membrane. Theossicular chain damage is found in both mucosal and squamosal types of COM. We aim to evaluate relationship between preoperative otologic features, pure tone audiometric findings and intraoperative ossicular chain status in patients with chronic otitis media. <strong>Material and Methods:</strong> 100 patients of either sex aged between 12 to 60 years operated for active or inactive, squamosal or mucosal chronic otitis media attending Ram Lal Eye and ENT Hospital, Government Medical College Amritsar were taken. The preoperative ossicular chain status based on set parameters was compared with the intraoperative ossicular chain status. <strong>Results:</strong> The ossicular chain integrity is more commonly compromised in squamosal COM and the most common ossicle eroded is Incus. Pure tone audiogram has got a very important role in determining the ossicular chain integrity preoperatively and must be done in all cases with accuracy. <strong>Conclusion:</strong> It is concluded that on the basis of otoscopic examination and pure tone audiometry values, we can accurately classify the COM as mucosal or squamosal type and get an idea of the ossicular chain integrity preoperatively hence planning the extent of surgery.展开更多
文摘Background:Otoscopy examination can be challenging.Traditional teaching uses still image illustrations.Newer attempts use video samples to simulate the otoscopy exam which is a dynamic process.Aims/Objective:To assess whether recorded otoscopy videos from a smartphone adaptable otoscope can be used to develop a video-based otoscopy quiz which may be used for instructing and familiarizing participants to normal anatomy and pathologic ear conditions.To use this quiz to assess current pediatric residents’competency of common otoscopy diagnosis.Method and materials:This study was conducted in 2018.Video samples of ear pathology were collected at the Albany Medical Center using a smartphone adaptable otoscope-Cellscope.The videos were used to create a video otoscopy quiz(VOQ)without clinical vignettes.45 pediatric residents from 3 academic institutions were evaluated with the quiz.Results:The weighted mean for the VOQ was 66.90%(95%CI 58.89%-68.42%).The breakdown by questions are:myringosclerosis 72.88%,retraction pocket 80.65%,cholesteatoma 42.22%,hemotympanum 75.04%,tympanic membrane perforation 79.62%,cerumen impaction 95.46%,otitis externa 52.54%,otitis media with effusion 63.30%,acute otitis media 75.55%,normal ear 36.39%.Conclusion:We found that videos of otoscopy exams can be obtained with a smartphone adaptable otoscope and validated to develop a video-based quiz,which may be used to supplement otoscopic instruction.Following our testing process,we found pediatric residents are relatively well equipped to identify ear pathology on VOQ.
基金The Science and Technology Planning Projects of Guangdong Province(Grant No.2018B010109008)National Key R&D Program of China(Grant No.2018YFC0116500)+1 种基金Key R&D Program of Guang-dong Province,China(Grant No.2018B030339001)Medical artifi-cial intelligence project of Sun Yat-Sen Memorial Hospital(Grant No.YXYGZN201904).
文摘Middle and outer ear diseases are common otological diseases worldwide.Otoscopy and otoendoscopy exami-nations are essential first steps in the evaluation of patients with otological diseases.Misdiagnosis often occurs when the doctor lacks experience in interpreting the results of otoscopy or otoendoscopy,leading to delays in treatment or complications.Using deep learning to process otoscopy images and developing otoscopic artificial-intelligence-based decision-making systems will become a significant trend in the future.However,the uneven quality of otoscopy images is among the major obstacles to development of such artificial intelligence systems,and no standardized process for data acquisition,and annotation of otoscopy images in intelligent medicine has yet been fully established.The standards for data storage and data management are unified with those of other specialties and are introduced in detail here.This expert recommendation criterion improved and standardized the collection and annotation procedures for otoscopy images and fills the current gap in otologic intelligent medicine;it would thus lay a solid foundation for the standardized collection,storage,and annotation of oto-scopy images and the application of training algorithms,and promote the development of automatic diagnosis and treatment for otological diseases.The full text introduced image collection(including patient preparation,equipment standards,and image storage),image annotation standards,and quality control.
文摘Gout is the most common cause of monoarthritis in men occurring classically in the great toe and the knee.Extra-articular gout manifestations are rare.Only a few cases of head and neck urate crystals deposits have been described in the literature.Precipitations in the middle ear cause conductive hearing loss with common otoscopic anomalies and difficult imaging diagnosis.We report a case of a healthy 58-years-old man with a middle ear urate deposit causing a progressive hearing loss as the very first symptom of gout.The nature of the deposit was unsure on computer tomography(CT)due to atypical density.The final diagnosis was revealed after surgical procedure and histologic examination.A review of the literature is also presented.Seven cases of middle ear urate deposit as the first symptom of gout were found and compared.Progressive conductive hearing loss in middle-aged patients with abnormal otoscopy and middle ear atypical density mass on CT scan must lead to a minimal surgical procedure with a histologic examination to exclude urate crystals deposits.
文摘<strong>Aim:</strong> Chronic otitis media (COM) is chronic muco purulent discharge through a perforated tympanic membrane. Theossicular chain damage is found in both mucosal and squamosal types of COM. We aim to evaluate relationship between preoperative otologic features, pure tone audiometric findings and intraoperative ossicular chain status in patients with chronic otitis media. <strong>Material and Methods:</strong> 100 patients of either sex aged between 12 to 60 years operated for active or inactive, squamosal or mucosal chronic otitis media attending Ram Lal Eye and ENT Hospital, Government Medical College Amritsar were taken. The preoperative ossicular chain status based on set parameters was compared with the intraoperative ossicular chain status. <strong>Results:</strong> The ossicular chain integrity is more commonly compromised in squamosal COM and the most common ossicle eroded is Incus. Pure tone audiogram has got a very important role in determining the ossicular chain integrity preoperatively and must be done in all cases with accuracy. <strong>Conclusion:</strong> It is concluded that on the basis of otoscopic examination and pure tone audiometry values, we can accurately classify the COM as mucosal or squamosal type and get an idea of the ossicular chain integrity preoperatively hence planning the extent of surgery.
