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Otoscope Exam

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1. Otoscope Exam

Otoscope Exam Otoscope Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Otoscope Exam Otoscope Exam Aka: Otoscope Exam , Otoscopy (...) , Pneumatic Otoscopy , Tympanic Membrane exam II. Preparation Adequate viewing requires >100 foot candles light Change otoscope bulbs periodically (after 20h use) III. Technique: Observation Assessment of Color and Appearance Yellow (amber) serous fluid behind TM Suggests Air bubbles may also be seen in serous otitis Marked erythema may suggest and crying can also bring this on Landmarks obscured Suggests Position Bulging TM suggests Retracted TM suggests Mobility Immobile TM suggests effusion Assessment

2018 FP Notebook

2. Diagnosing acute otitis media using a smartphone otoscope; a randomized controlled trial. (PubMed)

department. Participants were a convenience sample of preschool children, consulting for fever and respiratory symptoms. All children were evaluated by two residents randomized to use the CellScope Oto® smartphone device or a traditional otoscope. The primary outcome was the diagnostic accuracy of residents in ear evaluation compared to pediatric otolaryngologist's using binocular microscopy. Secondary outcomes included the need for a second ear exam by the treating physician and parental (...) preference.Between August 2015 and June 2016, 90 residents examined 100 patients. Six patients were excluded, leaving 94 children evaluated twice. Diagnostic accuracies were 0.69 (95% CI: 0.52 to 0.75) for the residents using a traditional otoscope and 0.74 (95% CI: 0.68 to 0.80) for those using the CellScope Oto® for an absolute difference of 0.06 (95% CI: -0.03 to 0.15). The emergency physicians reported no need for a control exam in 49/91 (54%) situations. Finally, 44 (47%) families preferred the CellScope

2018 American Journal of Emergency Medicine

3. iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents? (PubMed)

iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents? Tele-otoscopy has been validated for tympanostomy surveillance and remote diagnosis when images are recorded by trained professionals. The CellScope iPhone Otoscope is a device that may be used for tele-otoscopy and it enables parents to record their children's ear examinations and send the films for remote physician diagnosis. This study aims to determine the ability to diagnose, and the reliability (...) of the diagnosis when utilizing video exams obtained by a parent versus video exams obtained by an otolaryngologist.Parents of children ages 17 years or younger attempted recordings of the tympanic membrane of their children with the CellScope after a video tutorial; a physician subsequently used the device to record the same ear. Recordings occurred prior to standard pediatric otolaryngology office evaluation. Later, a remote pediatric otolaryngologist attempted diagnosis solely based on the videos, blinded

2018 International Journal of Pediatric Otorhinolaryngology

4. Pediatric Emergency Department Smartphone Otoscope Study (PED-Oto)

diagnosed when visualization of the tympanic membrane (ear drum) is not optimal. Improved methods for visualizing the tympanic membrane including capturing still images and recording video of the ear exam would be beneficial in the diagnosis and management of otic complaints, including acute and chronic otitis media. Use of a smartphone otoscope has the potential to optimize clinician ability to manage otic complaints, visualize the tympanic membrane, and support antimicrobial stewardship. This study (...) clinicians for the 6-month study period; 10 who will be randomly assigned to use a smartphone otoscope for the 6-month study period and 10 who will be assigned to use a conventional otoscope for all otoscopic exams. Data will be abstracted via retrospective review of the electronic medical record of encounters in with an otoscopic exam was performed as part of the diagnostic evaluation. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment

2016 Clinical Trials

5. Evaluation of an iPhone Otoscope in a Neurotrauma Clinic and as an Adjunct to Neurosurgical Education (PubMed)

with any CellScope visualized abnormalities. Medical students, P.A.s, residents, and attendings were surveyed before and after using CellScope to assess their comfort and skill in completing an otological exam, as well as their opinion on the utility of CellScope in their medical training.18 medical professionals were surveyed before and after the use of CellScope. Surveys were graded on a 1-5 scale and indicated a greater preference for the CellScope (4.7/5.0) versus the otoscope (3.16/5.0). Similarly (...) Evaluation of an iPhone Otoscope in a Neurotrauma Clinic and as an Adjunct to Neurosurgical Education CellScope®, an iPhone-enabled otoscope, was introduced into the neurotrauma clinic at an American College of Surgeons certified Level I trauma center. CellScope is an innovative tool that digitally improves optical clarity of the tympanic membrane, providing the acquisition of HIPPA compliant images. We compared the CellScope to the traditional otoscope in teaching medical students

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2016 Insights in neurosurgery

6. Otoscope Exam

Otoscope Exam Otoscope Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Otoscope Exam Otoscope Exam Aka: Otoscope Exam , Otoscopy (...) , Pneumatic Otoscopy , Tympanic Membrane exam II. Preparation Adequate viewing requires >100 foot candles light Change otoscope bulbs periodically (after 20h use) III. Technique: Observation Assessment of Color and Appearance Yellow (amber) serous fluid behind TM Suggests Air bubbles may also be seen in serous otitis Marked erythema may suggest and crying can also bring this on Landmarks obscured Suggests Position Bulging TM suggests Retracted TM suggests Mobility Immobile TM suggests effusion Assessment

2015 FP Notebook

7. Cholesteatoma

based on history and otoscopic findings. CT scan provides lesion definition and extent. Treatment is surgical removal. Adjunctive topical antimicrobial treatment may help reduce acute symptoms preoperatively. Complications include recurrence, meningitis, facial palsy, and a labyrinthine fistula. Definition Cholesteatoma is defined as the presence of keratinising squamous epithelium within the middle ear, or in other pneumatised areas of the temporal bone. Fisch U, May JS, Linder T. Mastoidectomy (...) cholesteatoma. Heilbrun ME, Salzman KL, Glastonbury CM, et al. External auditory canal cholesteatoma: clinical and imaging spectrum. AJNR Am J Neuroradiol. 2003 Apr;24(4):751-6. http://www.ajnr.org/cgi/content/full/24/4/751 http://www.ncbi.nlm.nih.gov/pubmed/12695217?tool=bestpractice.com History and exam presence of risk factors hearing loss ear discharge resistant to antibiotic therapy attic crust in retraction pocket white mass behind intact tympanic membrane tinnitus otalgia altered taste dizziness

2018 BMJ Best Practice

8. Supplemental Project to Assess the Transparency of Reporting Requirements: Tympanostomy Tubes in Children With Otitis Media

, otic or systemic antibacterial drug use for any reason any time post-surgery, as well as patients who missed visits or were lost-to-follow-up. Secondary Adverse events, otoscopic exams, audiometry, and tympanometry Microbiological response Mair 2016 26985629 Treatment failure: (1) the presence of postoperative otorrhea in one or both ears during the visual external ear examination on or after 3 postoperative day (day4); (2) the patient received otic antibiotic drops any time after surgery

2017 Effective Health Care Program (AHRQ)

9. Tympanostomy Tubes in Children with Otitis Media

to 12 NR Antibiotic prophylaxis (25) vs. Oral steroid (25) vs. Placebo (25) vs. TT +/- adenoidectomy (25) Composite cure (appearance, audiometry, tympanography) Gates 1987 3683478 U.S. 88 suspected SOM with MEE persisting >= 2 months 4 to 8 4/1980- 6/1984 TT (129) vs. Myringotomy (107) vs. vs. TT & Adenoidectomy (125) vs. Myringotomy & Adenoidectomy (130) Time with abnormal hearing & time with HL >= 20 dB Percent time with effusion & time to 1st recurrence, proportion of exams with effusion Mandel (...) Australia 76 adenoidectomy (7534) Kobayashi 2012 22386274 Japan 79 1996-1999 Early TT (82) vs. late TT (bilateral: 6 mo, unilateral: 3 mo) (100) Cleft palate No Language development Kuscu 2015 26545930 Turkey 86 2008-2013 early TT (67) vs. late TT (22) vs. no TT (65) Cleft palate No Hearing level, otoscopic findings Li 2015 26281253 China 84 2002 - 2012 TT (248) vs. Myringotomy (276) Cleft palate No Cure, Recurrence Li 2015 26281253 China 84 2003 - 2012 TT (78) vs. Myringotomy (168) Adenoidal

2017 Effective Health Care Program (AHRQ)

10. Tinnitus

carotid May Be Appropriate O CT temporal bone with IV contrast May Be Appropriate ??? CT temporal bone without and with IV contrast Usually Not Appropriate ??? ACR Appropriateness Criteria ® 2 Tinnitus Variant 2: Asymmetric or unilateral, subjective, nonpulsatile tinnitus (no otoscopic finding; no asymmetric hearing loss, neurologic deficit, or trauma). Procedure Appropriateness Category Relative Radiation Level MRI head and internal auditory canal without and with IV contrast Usually Appropriate O (...) as the prime cause of pulsatile tinnitus [27]. Elevated extracranial carotid resistive indices and end diastolic velocity may be seen in the setting of intracranial vascular abnormalities [36], and should be addressed with intracranial modalities discussed above. Variant 2: Asymmetric or unilateral, subjective, nonpulsatile tinnitus (no otoscopic finding; no asymmetric hearing loss, neurologic deficit, or trauma). Nonpulsatile tinnitus may be described as ringing, buzzing, or clicking sensations

2017 American College of Radiology

11. Management of Concussion-mild Traumatic Brain Injury (mTBI)

criteria obtained during a history and physical exam (see Algorithms for definition). Symptoms associated with mTBI are identified while conducting the history of present illness. The signs and symptoms associated with mTBI are evaluated through physical examination and history and are treated in accordance with this guideline. This recommendation was not reviewed in the recent literature review; however, the strength of this recommendation is strong. The content of the 2009 mTBI CPG was reviewed (...) and generally accepted as current best practice. The Work Group recognized primary care providers should consider, as appropriate during each encounter, the following physical findings, signs and symptoms (“red flags”) that may indicate a neurologic condition that requires urgent specialty consultation (e.g., consultation with neurology, neuro-surgical): • Progressively declining level of consciousness • Progressively declining neurological exam • Pupillary asymmetry • Seizures • Repeated vomiting

2016 VA/DoD Clinical Practice Guidelines

12. Late Effects of Treatment for Childhood Cancer (PDQ®): Patient Version

of cancer, the type of treatment, factors, and the person's general health and health habits. Follow-up care includes checking for and of late effects and health education on how to prevent or lessen late effects. It is important that childhood cancer survivors have an exam at least once a year. The exams should be done by a health professional who knows the survivor's risk for late effects and can recognize the early signs of late effects. Blood and may also be done. Long-term follow-up may improve (...) treatment the patient had in the past. All patients who have been treated for cancer should have a and done once a year. A physical exam of the body is done to check general of health, including checking for signs of disease, such as lumps, changes in the skin, or anything else that seems unusual. A medical history is taken to learn about the patient’s health habits and past illnesses and treatments. If the patient received radiation therapy, the following tests and procedures may be used to check

2018 PDQ - NCI's Comprehensive Cancer Database

15. Novel use of video glasses during binocular microscopy in the otolaryngology clinic. (PubMed)

of the potential benefits of the enhanced display option.This study was comprised of a single treatment group. Patients seen in the otolaryngology clinic who required binocular microscopy for diagnosis and treatment were recruited. All patients wore video glasses during their otoscopic examination. An additional cohort of patients who required binocular microscopy were also recruited, but did not use the video glasses during their examination. Patients subsequently completed a 10-point Likert scale survey (...) that assessed their comfort, anxiety, and satisfaction with the examination as well as their general understanding of their otologic condition.A total of 29 patients who used the video glasses were recruited, including those with normal examinations, cerumen impaction, or chronic ear disease. Based on the survey results, patients reported a high level of satisfaction and comfort during their exam with video glasses. Patients who used the video glasses did not exhibit any increased anxiety

2018 American Journal of Otolaryngology

16. Late Effects of Treatment for Childhood Cancer (PDQ®): Patient Version

of cancer, the type of treatment, factors, and the person's general health and health habits. Follow-up care includes checking for and of late effects and health education on how to prevent or lessen late effects. It is important that childhood cancer survivors have an exam at least once a year. The exams should be done by a health professional who knows the survivor's risk for late effects and can recognize the early signs of late effects. Blood and may also be done. Long-term follow-up may improve (...) treatment the patient had in the past. All patients who have been treated for cancer should have a and done once a year. A physical exam of the body is done to check general of health, including checking for signs of disease, such as lumps, changes in the skin, or anything else that seems unusual. A medical history is taken to learn about the patient’s health habits and past illnesses and treatments. If the patient received radiation therapy, the following tests and procedures may be used to check

2016 PDQ - NCI's Comprehensive Cancer Database

18. A love letter to patients

your chronic disease has a ripple effect that extends to your family, your friends, and even your community. If you ceased to share your stories with us, we would never learn some of the most important things about the art of medicine. Medicine is complex, and we also must practice our skills many times to become proficient. You may watch us as we fumble with an otoscope the first few times we do ear exams, as we use an incorrectly sized blood pressure cuff, or as we realize a minute too late

2017 KevinMD blog

19. Improving learning and confidence through small group, structured otoscopy teaching: a prospective interventional study (PubMed)

Improving learning and confidence through small group, structured otoscopy teaching: a prospective interventional study Otologic diseases are common and associated with significant health care costs. While accurate diagnosis relies on physical exam, existing studies have highlighted a lack of comfort among trainees with regards to otoscopy. As such, dedicated otoscopy teaching time was incorporated into the undergraduate medical curriculum in the form of a small group teaching session (...) . In this study, we aimed to examine the effect of a small-group, structured teaching session on medical students' confidence with and learning of otoscopic examination.Using a prospective study design, an otolaryngologist delivered an one-hour, small group workshop to medical learners. The workshop included introduction and demonstration of otoscopy and pneumatic otoscopy followed by practice with peer feedback. A survey exploring students' confidence with otoscopy and recall of anatomical landmarks

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2017 Journal of Otolaryngology - Head & Neck Surgery

20. Combined Access Closed Tympanomastoidectomy: Microsurgery Allied to Endoscopy

. Herewith, the best visualization of the surgical site facilitates the full removal of the cholesteatoma. In addition to that, the combined technique is less invasive than the standard one, since less bone debridement is required to access the surgical site. The outcomes of the study will be evaluated through follow up medical appointments and exams. The patients will be followed by monthly medical appointments with otoscopic evaluations for diagnose of possible recurrence of the disease or residual (...) cholesteatoma. Also, audiometry exams will be performed in the third, sixth and twelfth months. Image exams such as nuclear magnetic resonance may be performed at the end of this period to evaluate relapse of the disease if the otoscopic evaluation is inconclusive. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 56 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose

2017 Clinical Trials

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