New Approaches and Technologies to Improve Accuracy of Acute Otitis Media Diagnosis

Abstract

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.

A Deep Learning Approach to Predict Conductive Hearing Loss in Patients With Otitis Media With Effusion Using Otoscopic Images

“…39,40 Furthermore, it should be noted that there are several influencing factors that affect the observation of the tympanic membrane and thus the accuracy in diagnosis during otoscopic examination, such as in the conditions when the external ear canal is partly or completely blocked by cerumen, or when children are unable or unwilling to cooperate with the examination. [41][42][43][44] Therefore, it is crucial to obtain high-quality otoscopic images as input data to ensure a reliable and accurate DL model for predicting CHL in ears with OME.…”

“…Previous studies have suggested that the diagnostic accuracy for detecting OME using otoscopy is between 60% and 70%, whereas the sensitivity and specificity of tympanometry can reach to 70% to 90% for the detection of OME, but it is dependent on patient cooperation . Furthermore, it should be noted that there are several influencing factors that affect the observation of the tympanic membrane and thus the accuracy in diagnosis during otoscopic examination, such as in the conditions when the external ear canal is partly or completely blocked by cerumen, or when children are unable or unwilling to cooperate with the examination . Therefore, it is crucial to obtain high-quality otoscopic images as input data to ensure a reliable and accurate DL model for predicting CHL in ears with OME.…”

Smartphone-Based Artificial Intelligence for the Detection and Diagnosis of Pediatric Diseases: A Comprehensive Review

“…Otomicroscopy, tympanocentesis (TYM), pneumatic otoscopy (PO), tympanometry (TP), and acoustic reflectometer (AR) have been largely studied in this regard. Despite the fact that, in several trials, especially when these diagnostic methods were used in association, they have allowed a significantly reduced misdiagnosis of AOM and OME, their use in outpatients by primary care pediatricians and general practitioners has remained very poor [ 17 ]. This is because performing and interpreting results offered by these diagnostic methods require extensive training or extended practice, and, at least in some cases, the instruments are very expensive or too invasive.…”

Evaluation of the efficacy and tolerability of the combination of lidocaine + phenazone in the local therapy of acute otitis media at the doperforative stage in adults

“…Статистика встречаемости острого среднего отита во взрослой популяции отсутствует, однако имеются данные, что более 25% пациентов со стойкой тугоухостью имеют в анамнезе острое или хроническое воспалительное заболевание среднего уха. Актуальным для клинической практики остается риск осложненного течения ОСО с развитием мастоидита, которое имеет место у 0,4% пациентов [1][2][3][4][5].…”

“…Вирусными возбудителями ОСО являются пикорнавирусы, респираторно-синцитиальный вирус (РСВ), коронавирусы, вирусы гриппа, аденовирусы, метапневмовирус и бокавирус человека и некоторые другие. Важным доказательством этиотропной роли вирусов являются данные о том, что при ОСО они обнаруживаются в большинстве мазков из носоглотки и до 70% образцов жидкости из среднего уха [1][2][3][4][6][7][8][9][10][11][12]. Наиболее распространенными бактериальными патогенами, вызываю щими ОСО, являются Streptococcus pneumoniae и Haemophilus influenzae, которые ответственны за более чем 95% случаев развития заболевания.…”