Importance of diffusion weighted magnetic resonance imaging at differentiation of cholesteatoma and granulation tissue in patients with chronic suppurative otitis media

Tuzcu, Göksel; Yardımcı, Aytül Hande; Turna, Önder; Göner, Reyyan Elif; Acıoğlu, Engin

doi:10.5606/kbbihtisas.2015.25675

Cited by 2 publications

(2 citation statements)

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“…Some degree of discordance in diagnosis is not unexpected; there was disagreement in differentiating a retraction pocket of the tympanic membrane from a perforation or healed perforation (cases 21, 39, 48), in differentiating the presence or absence of middle ear effusion (case 19) and in differentiating mucosal CSOM from cholesteatoma (case 3). Previous studies have reported discordance between observers in otoscopic diagnosis of middle ear effusion or tympanic membrane retraction and between cholesteatoma and mucosal CSOM . Hence, a 5% discordance in diagnosis may reflect expected differences in expert opinion and not necessarily a limitation of the tool used for assessment.…”

Section: Discussionmentioning

confidence: 93%

“…Some degree of discordance in diagnosis is not unexpected; there was disagreement in differentiating a retraction pocket of the tympanic membrane from a perforation or healed per- 18,19 and between cholesteatoma and mucosal CSOM. [20][21][22] Hence, a 5% discordance in diagnosis may reflect expected differences in expert opinion and not necessarily a limitation of the tool used for assessment.…”

Section: Synopsis Of Findings and Clinical Applicabilitymentioning

confidence: 99%

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A cross‐sectional evaluation of the validity of a smartphone otoscopy device in screening for ear disease in Nepal

Mandavia

Lapa

Smith³

et al. 2017

Clinical Otolaryngology

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Objectives Hearing loss is a neglected international health problem. The greatest burden of ear disease is in low‐income countries where there is also a lack of resources. In this context, screening for otological disease may be worthwhile. Cupris© has developed an otoscopy device that offers the possibility of low‐cost mass screening in remote communities. We evaluated the validity of this device in diagnosing ear disease and in determining whether referral to an ENT centre is warranted. Design Cross‐sectional study. Setting Outpatient clinic, Nepal. Participants All adults and children were invited to take part over a 2‐day period. The Cupris© device was used to record participants otological history and examination. Stored history and images were assessed in the United Kingdom by a Consultant‐grade ENT Surgeon, who provided a diagnosis and decided whether referral to an ENT centre was warranted. After screening with the Cupris© device, participants were immediately assessed by a UK trained ENT Consultant Surgeon using a standard otoscope (“standard assessment”). A diagnosis was recorded for each participant and a decision was made as to whether referral to an ENT centre was warranted. Outcomes Concordance in primary diagnosis (analysed per ear) and concordance in the decision to refer (analysed per patient). Cohen's kappa coefficient for inter‐rater agreement in diagnosis. Results Fifty‐six patients agreed to participate. In four patients, the quality of video recorded precluded a diagnosis or management plan. These patients were excluded from subsequent analysis, leaving 52 patients for analysis. The same diagnosis was reached for 99 of 104 ears when comparing the Cupris© device to standard assessment (95% concordance), with Cohen's kappa coefficient of 0.89. The decision as to whether a patient should be referred to an ENT centre for further assessment was the same for all 52 participants when comparing the Cupris© device to standard assessment. Conclusions When compared to standard assessment, the Cupris© device is a valid tool for the diagnosis of ear disease and decision for onward referral. It shows considerable promise for use by trained non‐medical workers, as a low‐cost and portable tool to screen for ear disease in remote settings, particularly in low‐ and middle‐income countries.

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Section: Discussionmentioning

confidence: 93%

“…Some degree of discordance in diagnosis is not unexpected; there was disagreement in differentiating a retraction pocket of the tympanic membrane from a perforation or healed per- 18,19 and between cholesteatoma and mucosal CSOM. [20][21][22] Hence, a 5% discordance in diagnosis may reflect expected differences in expert opinion and not necessarily a limitation of the tool used for assessment.…”

Section: Synopsis Of Findings and Clinical Applicabilitymentioning

confidence: 99%