-
Chemical Society Reviews Apr 2016Clinical diagnostic devices provide new sources of information that give insight about the state of health which can then be used to manage patient care. These tools can... (Review)
Review
Clinical diagnostic devices provide new sources of information that give insight about the state of health which can then be used to manage patient care. These tools can be as simple as an otoscope to better visualize the ear canal or as complex as a wireless capsule endoscope to monitor the gastrointestinal tract. It is with tools such as these that medical practitioners can determine when a patient is healthy and to make an appropriate diagnosis when he/she is not. The goal of diagnostic medicine then is to efficiently determine the presence and cause of disease in order to provide the most appropriate intervention. The earliest form of medical diagnostics relied on the eye - direct visual observation of the interaction of light with the sample. This technique was espoused by Hippocrates in his 5th century BCE work Epidemics, in which the pallor of a patient's skin and the coloring of the bodily fluids could be indicative of health. In the last hundred years, medical diagnosis has moved from relying on visual inspection to relying on numerous technological tools that are based on various types of interaction of the sample with different types of energy - light, ultrasound, radio waves, X-rays etc. Modern advances in science and technology have depended on enhancing technologies for the detection of these interactions for improved visualization of human health. Optical methods have been focused on providing this information in the micron to millimeter scale while ultrasound, X-ray, and radio waves have been key in aiding in the millimeter to centimeter scale. While a few optical technologies have achieved the status of medical instruments, many remain in the research and development phase despite persistent efforts by many researchers in the translation of these methods for clinical care. Of these, Raman spectroscopy has been described as a sensitive method that can provide biochemical information about tissue state while maintaining the capability of delivering this information in real-time, non-invasively, and in an automated manner. This review presents the various instrumentation considerations relevant to the clinical implementation of Raman spectroscopy and reviews a subset of interesting applications that have successfully demonstrated the efficacy of this technique for clinical diagnostics and monitoring in large (n ≥ 50) in vivo human studies.
Topics: Clinical Laboratory Techniques; Diagnostic Imaging; Humans; Spectrum Analysis, Raman
PubMed: 26999370
DOI: 10.1039/c5cs00581g -
Current Opinion in Pediatrics Dec 2016In the age of targeted genomic enrichment and massively parallel sequencing, there is no more efficient genetic testing method for the diagnosis of hereditary hearing... (Review)
Review
PURPOSE OF REVIEW
In the age of targeted genomic enrichment and massively parallel sequencing, there is no more efficient genetic testing method for the diagnosis of hereditary hearing loss. More clinical tests are on the market, which can make choosing good tests difficult.
RECENT FINDINGS
More and larger comprehensive genetic studies in patients with hearing loss have been published recently. They remind us of the importance of looking for both single nucleotide variation and copy number variation in all genes implicated in nonsyndromic hearing loss. They also inform us of how a patient's history and phenotype provide essential information in the interpretation of genetic data.
SUMMARY
Choosing the most comprehensive genetic test improves the chances of a genetic diagnosis and thereby impacts clinical care.
Topics: DNA Copy Number Variations; Genetic Markers; Genetic Testing; Hearing Loss; High-Throughput Nucleotide Sequencing; Humans; Polymorphism, Single Nucleotide
PubMed: 27552069
DOI: 10.1097/MOP.0000000000000410 -
Brazilian Journal of Otorhinolaryngology 2024The video otoscope has already proven to be useful for the diagnosis of several pathologies, so the objective of this study was to evaluate the diagnostic accuracy of...
OBJECTIVE
The video otoscope has already proven to be useful for the diagnosis of several pathologies, so the objective of this study was to evaluate the diagnostic accuracy of the video otoscope in cases of tympanic membrane perforation.
METHODS
This is a diagnostic accuracy study performed at the hearing health division of a tertiary-level referral hospital. Patients older than 8 years of age who had any symptom that could be related to perforation (otalgia, otorrhea, tinnitus, and/or hypoacusis) were invited to participate in the study. Participants were evaluated by three different diagnostic methods (otomicroscope, conventional otoscope, and video otoscope) performed by three different evaluators in a blind fashion. The microscope was considered the reference standard.
RESULTS
176 patients were evaluated, totaling 352 tympanic membranes. Twenty-seven tympanic membrane perforations were diagnosed by the microscope, a prevalence of 7.7%. The video otoscope showed a sensitivity of 85.2% (95% CI 81.5%‒88.9%), specificity of 98.1% (95% CI 96.7%‒99.5%) and accuracy of 97.1% (95% CI 95.4 %-98.8 %). The conventional otoscope showed a sensitivity of 96.3% (95% CI 94.3-98.3), specificity of 98.8% (95% CI 97.7-99.9) and accuracy of 98.6% (95% CI 97.4-99.8). The Kappa value between the microscope and the video otoscope was 0.8 and between the microscope and the conventional otoscope was 0.9. Regarding the participants' perception, 53.4% (p< 0.001) considered the video otoscope as the best method for understanding the tympanic membrane condition presented by them.
CONCLUSIONS
The video otoscope showed relevant sensitivity and specificity for clinical practice in the diagnosis of tympanic membrane perforation. Moreover, this is an equipment that can facilitate the patient's understanding of the otologic pathology presented by him/her. In this regard, this method may be important for better patient compliance, requiring further studies to evaluate this hypothesis.
LEVEL OF EVIDENCE
Is this diagnostic or monitoring test accurate? (Diagnosis)-Level 2 (Individual cross-sectional studies with consistently applied reference standard and blinding).
Topics: Humans; Male; Female; Tympanic Membrane Perforation; Otoscopes; Cross-Sectional Studies; Otoscopy; Tympanic Membrane; Hearing Loss
PubMed: 37839169
DOI: 10.1016/j.bjorl.2023.101336 -
European Annals of Otorhinolaryngology,... Feb 2019General practitioners (GPs) play an essential role in the management of ear disease, but their diagnosis of pathologic eardrums is inadequate. The aim of this study was... (Comparative Study)
Comparative Study
INTRODUCTION
General practitioners (GPs) play an essential role in the management of ear disease, but their diagnosis of pathologic eardrums is inadequate. The aim of this study was to compare the quality of otoscopic diagnosis by GPs using a conventional otoscope versus a video-otoscope. Subjects and method Eleven GPs included 124 patients with ear complaints (193 otoscopies). Examination successively used conventional otoscopy and video-otoscopy. After each type of examination, a 10-criterion assessment questionnaire was filled out and a diagnosis was proposed. Two blinded ENT specialists reviewed the video-otoscopy images and filled out the same grid questionnaire to make their diagnosis. GPs also completed a Likert-scale satisfaction questionnaire on video-otoscopy.
RESULTS
There were no significant differences in overall examination results between the three groups (GP conventional otoscopy, GP video-otoscopy and ENT specialist). However, focusing exclusively on pathologic eardrums, there was a significant difference in results between ENT specialists and GPs using a conventional otoscope (P=0.0032); this was not the case when GPs used video-otoscopy (P=0.0754). All GPs expressed enthusiastic interest in video-otoscopy, even when not convinced to make the purchase.
CONCLUSION
Video-otoscopy showed superiority over conventional otoscopy in assessing pathological eardrums.
Topics: Adult; Attitude of Health Personnel; Ear Diseases; France; General Practitioners; Humans; Otolaryngologists; Otoscopy; Surveys and Questionnaires; Video Recording
PubMed: 30392875
DOI: 10.1016/j.anorl.2018.10.016 -
European Respiratory Review : An... Sep 2023Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by pulmonary, otological and sino-nasal manifestations. Well-defined clinical outcome measures... (Review)
Review
BACKGROUND
Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterised by pulmonary, otological and sino-nasal manifestations. Well-defined clinical outcome measures are needed in such rare diseases research to improve follow-up and treatments. Pulmonary outcome measures have recently been described. The aim of this study was to identify ear and upper airway outcome measures that could be used for longitudinal follow-up of individuals with PCD.
METHODS
A scoping review was performed by systematically searching MEDLINE, Embase and Cochrane Database of Systematic Reviews online databases for studies published from January 1996 to March 2022 that included at least 10 adult or paediatric PCD patients and reported ear and upper airway outcomes.
RESULTS
33 studies (1794 patients) were included. 10 ear and upper airway outcomes were reported. 17 studies reported audiometry, 16 reported otoscopic findings, and 13 reported rhinoscopic findings and sinus imaging. Health-related quality of life questionnaires were performed in seven studies. There was a high variability in definitions and measurement of outcomes between studies.
CONCLUSIONS
This scoping review highlights the lack of data regarding ear and upper airway outcomes in PCD. It also reports a high heterogeneity in outcome definitions or measures. We provide well-founded specific suggestions to standardise ear and upper airway outcome definitions and reporting for future PCD research studies.
Topics: Adult; Humans; Child; Quality of Life; Systematic Reviews as Topic; Rare Diseases; Ciliary Motility Disorders
PubMed: 37437912
DOI: 10.1183/16000617.0200-2022 -
Biomedical Optics Express Apr 2016We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical...
We designed and fabricated a novel terahertz (THz) otoscope to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application.
PubMed: 27446647
DOI: 10.1364/BOE.7.001201 -
Clinical Case Reports Jan 2024Oto-tricho is associated with the symptoms of gag reflex and non-neuropathic tinnitus, which can be treated by removing the hair and its follicle.
KEY CLINICAL MESSAGE
Oto-tricho is associated with the symptoms of gag reflex and non-neuropathic tinnitus, which can be treated by removing the hair and its follicle.
ABSTRACT
Oto-tricho refers to a disorder of hair growth in the tympanic membrane (TM). In its early stages, it can manifest as symptoms such as tinnitus, chronic pain, cough, and nausea. If left untreated, it can potentially lead to tympanosclerosis, TM micro-perforation, and hearing loss. In this report, we present a case study of a 33-year-old male with hair and follicle growth observed on the left TM. Over the course of the past year, the patient experienced various symptoms including tinnitus, dry cough, and chronic pain. An examination with an otoscope revealed the presence of oto-tricho-tussia/tinnitus. To address the issue, the hair and hair follicles were surgically removed using direct visual guidance. Subsequent follow-up was conducted over a period of 5 months, during which no pain or infection was observed at the site of the TM. The patient's previous symptoms were successfully resolved. Furthermore, further observation of the TM revealed no evidence of hair follicles or hair regrowth.
PubMed: 38173892
DOI: 10.1002/ccr3.8412 -
Frontiers in Medicine 2022Earwax (cerumen), a normal bodily secretion, can become a problem when it obstructs the ear canal. Earwax removal is a difficult task for specialists because of the... (Review)
Review
Earwax (cerumen), a normal bodily secretion, can become a problem when it obstructs the ear canal. Earwax removal is a difficult task for specialists because of the ear's unique location and the ear canal's intricate structure. Using ear scoops or cotton swabs to dig out ear wax in daily life is like "a blind man walking on a cliff." Improper operation may damage the ear canal or the eardrum. Thus, we need a pair of visible "eyes," otoscopes, to help us see earwax intuitively. As opposed to traditional otoscopes, which only serve as a visual aid, the endoscopic ear pick allows us to not only view the ear canal but also remove wax or other obstructions from the ear. In this review, we discussed endoscope ear pick pros and cons and discussed their future role.
PubMed: 36457570
DOI: 10.3389/fmed.2022.977554 -
Frontiers in Public Health 2022This study aimed to evaluate the effectiveness of smartphone otoscope telemedicine in the rural medical consortium in East China in the COVID-19 era.
PURPOSE
This study aimed to evaluate the effectiveness of smartphone otoscope telemedicine in the rural medical consortium in East China in the COVID-19 era.
METHODS
This prospective study was conducted within a rural medical consortium that provides health care services by integrating medical resources in the same area. When a patient visited primary health care (PHC) for ear diseases, the PHC provider used a smartphone otoscope to examine the patient's external ear canal and eardrum, and then sent photos or videos of the patient's ear to the otolaryngologist at the lead hospital WeChat group. The otolaryngologist provided remote diagnosis and management recommendations to the PHC provider. The following data were recorded: age and gender, outpatient diagnosis, disease duration, sides, duration of treatment, telemedicine visits, treatment outcomes, patient satisfaction, and PHC providers' self-evaluation score.
RESULTS
A total of 83 patients were included in the study, including 43 males and 40 females, with a mean age of 44.6 ± 19.7 years (range 3-83 years). The duration of treatment for these patients was 14.0 (7,14) days. PHC visits were 2.2 ± 1.1 times (range: 1-7 times). Telemedicine visits ranged from 1 to 5, with a mean of 1.8 ± 0.9. Among of patients, 62 (74.7%) were cured, 21 (25.3%) improved, and 0 (0%) were ineffective. Sixty-five patients (78.3%) were very satisfied, 16 (19.3%) patients were somewhat satisfied, and two patients (2.4%) were dissatisfied. Based on the self-reported helpfulness, the primary health care providers assessed telemedicine as very helpful ( = 63, 75.9%), helpful ( = 20, 24.1%), and unhelpful ( = 0, 0%).
CONCLUSIONS
Smartphone otoscope telemedicine in the medical consortium can effectively improve the ability of rural PHC providers to diagnose and treat ear diseases, save time and costs for patients, and improve patient satisfaction.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; COVID-19; Child; Child, Preschool; China; Ear Diseases; Female; Humans; Male; Middle Aged; Otoscopes; Prospective Studies; Smartphone; Telemedicine; Young Adult
PubMed: 35664106
DOI: 10.3389/fpubh.2022.879410 -
Diagnostics (Basel, Switzerland) Dec 2021Several studies have shown that in recent years incidence of acute otitis media (AOM) has declined worldwide. However, related medical, social, and economic problems for... (Review)
Review
Several studies have shown that in recent years incidence of acute otitis media (AOM) has declined worldwide. However, related medical, social, and economic problems for patients, their families, and society remain very high. Better knowledge of potential risk factors for AOM development and more effective preventive interventions, particularly in AOM-prone children, can further reduce disease incidence. However, a more accurate AOM diagnosis seems essential to achieve this goal. Diagnostic uncertainty is common, and to avoid risks related to a disease caused mainly by bacteria, several children without AOM are treated with antibiotics and followed as true AOM cases. The main objective of this manuscript is to discuss the most common difficulties that presently limit accurate AOM diagnosis and the new approaches and technologies that have been proposed to improve disease detection. We showed that misdiagnosis can be dangerous or lead to relevant therapeutic mistakes. The need to improve AOM diagnosis has allowed the identification of a long list of technologies to visualize and evaluate the tympanic membrane and to assess middle-ear effusion. Most of the new instruments, including light field otoscopy, optical coherence tomography, low-coherence interferometry, and Raman spectroscopy, are far from being introduced in clinical practice. Video-otoscopy can be effective, especially when it is used in association with telemedicine, parents' cooperation, and artificial intelligence. Introduction of otologic telemedicine and use of artificial intelligence among pediatricians and ENT specialists must be strongly promoted in order to reduce mistakes in AOM diagnosis.
PubMed: 34943628
DOI: 10.3390/diagnostics11122392