title: An innovative smartphone-based otorhinoendoscope and its application in mobile health and teleotolaryngology.
abstract: BACKGROUND
  The traditional otorhinoendoscope is widely used in the diagnosis of a variety of ear and nose diseases, but only one doctor can use it at a time. It is also very difficult to share observations from one doctor with another doctor. With advances in electronic health technology, the extended potential application of smartphones to support medical practice or mobile health has grown steadily.
  
  
  OBJECTIVE
  The first phase of the study discussed how smartphones may be used for otorhinoscopic imaging and image management via an innovative adaptor. The second phase of the study was to evaluate the diagnostic capability of the smartphone-based otorhinoendoscope, as compared to the traditional otorhinoendoscope, and its application in mobile health and teleotolaryngology.
  
  
  METHODS
  We designed a unique adaptor to connect the otorhinoendoscope and smartphone in order to perform smartphone-based otorhinoendoscopy. The main aim was to transform the smartphone into an otorhinoendoscope. We devised a method that would allow us to use the smartphone's camera to capture otorhinoscopic images. Using a freely available Web-based real-time communication application platform and the 3G (or WIFI) network, the smartphone-based otorhinoendoscope could synchronize the smartphone-based otorhinoscopic image with smartphones, tablet PCs, computer notebooks, or personal computers.
  
  
  RESULTS
  We investigated the feasibility of telemedicine using a smartphone, tablet PC, and computer notebook. Six types of clinical otorhinoscopic images were acquired via the smartphone-based otorhinoendoscope from six patients, which were examined in this study. Three teleconsultants (doctors A, B, and C) reviewed the six types of clinical otorhinoscopic images and made a telediagnosis. When compared to the face-to-face diagnosis, which was made in-person via a traditional otorhinoendoscope, the three teleconsultants obtained scores of a correct primary telediagnosis 83% (5/6), 100% (6/6), and 100% (6/6) of the time, respectively. When the clinical data were provided, the three teleconsultants obtained a correct secondary telediagnosis score of 100% (6/6), 100% (6/6), and 100% (6/6) of the time, respectively.
  
  
  CONCLUSIONS
  The use of previously available technologies in the absence of any additional expensive devices could significantly increase the quality of diagnostics while lowering extraneous costs. Furthermore, this could also increase the connectivity between most isolated family doctors and remote referral centers.
authors.affiliation: Department of Otolaryngology, Head And Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-Jung
authors.identifier: 0000-0002-7443-2119
authors.initials: CJ
authors.lastname: Wu
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Wu
authors.forename: Po-Chun
authors.initials: PC
authors.lastname: Chen
authors.forename: Yaoh-Shiang
authors.initials: YS
authors.lastname: Lin
mesh_terms: D040421:Cell Phone; D019723:Endoscopes; D006801:Humans; D010036:Otolaryngology / Q000295:instrumentation*; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis; D017216:Telemedicine / Q000295:instrumentation*
keywords: mobile health; otorhinoendoscope; smartphone; telediagnosis; teleotolaryngology