Objectives: This study investigates the possible benefits and limitations of the digital image enhancement systems provided by Storz Professional Image Enhancement System (SPIES) during endoscopic ear surgery (EES) for cholesteatoma. An increased detection of cholesteatoma residuals during the final steps of endoscopic surgery using DIE technology was hypothesized.
Objective: This study evaluates the benefits and limitations of selected
modalities of digital image enhancement in detection of cholesteatoma
remnants during endoscopic ear surgery (EES) and compares their
usefulness in recognizing residual disease. Study Design:
Cross-sectional study Setting: Tertiary referral hospital Methods: A
total of 10 questionnaires of 18 intraoperative pictures with equal
numbers of cholesteatoma and non-cholesteatoma images, each presented in
three different image enhancing modalities (clara, spectra A, spectra
B), were generated. Fifty-one experienced ear surgeons participated in
the survey and were randomly assigned to a questionnaire and completed
it at two time points. The experts were asked to rate for each picture
whether cholesteatoma was present or not. Results Clara showed the
highest accuracy in cholesteatoma detection, followed by spectra A and
lastly spectra B. In contrast, spectra B showed the highest sensitivity
and clara the highest specificity, while spectra A was placed in the
middle for both values. Using the spectra B modality, most responses
agreed across the two time points,. Ear surgeons assessed the
usefulness, as well as preference among image modalities in the
following order: clara, spectra B, spectra A. Conclusion The suitability
of image enhancement techniques for application in EES could be shown.
Clara can be considered the state-of-art technique throughout the
procedure and has subjectively been evaluated best by surgeons. Due to
its high sensitivity, spectra B is recommended regarding the final check
after resection to prevent cholesteatoma residuals.
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