title: Smartphone-Enabled Otoscopy in Neurotology/Otology.
abstract: Objective A smartphone-enabled otoscope (SEO) can capture tympanic membrane (TM) images. We sought to compare a SEO to microscopic otoscopy in the detection and evaluation of TM pathology in an otology/neurotology practice. Study Design Prospective single-site study in adults presenting over a 3-month period. Setting Neurotology clinic within a tertiary care academic medical center. Subjects and Methods Following consent, 57 patients underwent a medical and microscopic ear examination. Afterward, clinicians photographed bilateral TMs using a SEO. A second "blinded" neurotologist received a SEO-acquired image of each TM and a brief patient history. Our primary end point was identification of TM pathology (or lack thereof) and the blinded neurotologists' corresponding diagnosis. Secondary end points included patient-reported SEO comfort levels. Results A single SEO-acquired TM image and brief patient history resulted in correct diagnosis of 96% (23/24) of normal TMs and identification of 100% (33/33) of microscope-confirmed abnormal TMs. When pathology was identified by the "blinded" physician, the diagnosis was identical to that made by the primary treating physician 82% (27/33) of the time. On patient surveys, 93% (53/57) of patients felt "very comfortable" with SEO utilization, and 88% (50/57) reported viewing acquired images was "very useful" in understanding their condition. Conclusion A SEO is 96% specific in identifying normal TMs and 100% sensitive in identifying pathology. Its 97% positive predictive value and small false-positive rate makes it a useful screening tool. Furthermore, patients are receptive to this technology and felt comfortable with its utilization in a health care or possible telemedicine setting.
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Omid
authors.initials: O
authors.lastname: Moshtaghi
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Sahyouni
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Yarah M
authors.initials: YM
authors.lastname: Haidar
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Huang
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Afsheen
authors.initials: A
authors.lastname: Moshtaghi
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Ghavami
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.
authors.forename: Harrison W
authors.initials: HW
authors.lastname: Lin
authors.affiliation: 1 Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California, USA.|2 Division of Neurotology and Skull Base Surgery, Department of Biomedical Engineering, University of California, Irvine, Irvine, California, USA.
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Djalilian
mesh_terms: D004427:Ear Diseases / Q000175:diagnosis*; D006801:Humans; D063165:Neurotology / Q000295:instrumentation / Q000379:methods; D010036:Otolaryngology / Q000295:instrumentation / Q000379:methods; D019720:Otoscopes; D038781:Otoscopy; D011446:Prospective Studies; D000068997:Smartphone; D014432:Tympanic Membrane
keywords: CellScope; iPhone; microscope; mobile; otology; otoscope; smartphone; telemedicine