New technology optimizes ear infection diagnosis and management
A new, smartphone-enabled otoscope provides clear, transmittable images of the ear drum, or tympanic membrane, which someday may allow for ear infection diagnosis without a visit to the doctor’s office, according to an abstract presented Monday, Oct. 28, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in Orlando.
In the study, “Comparative Assessment of a Smartphone Otoscope for the Diagnosis and Management of Acute Otitis Media,” researchers studied the effectiveness of a smartphone otoscope attachment and app in accurately diagnosing acute otitis media (AOM), or ear infections, in children.
The research involved 63 children with upper respiratory symptoms who sought care at a single, major urban emergency department (ED) between May and December 2012. Each child was examined with a conventional otoscope as well as with the CellScope Oto, a new device that attaches to a smartphone providing video of the inner ear through an app.
Forty-nine children (mean age, 2.9) were diagnosed with AOM. There was no difference in the diagnostic quality or confidence ratings between devices by independent physicians who viewed the images captured by researchers. Diagnosis and treatment recommendations also were comparable by device.
The smartphone app facilitates viewing a child’s ear tympanic membrane. Ninety-five percent of parents responded favorably to viewing the images, and also said they would feel comfortable operating the attachment and app on their own.
“The CellScope Oto allows parents to see what the doctor sees, which helps them to better understand the child’s diagnosis and treatment,” said study author Kathryn Rappaport, MD. In addition, the video images provide a baseline and ongoing documentation of the child’s ear infections.
“Now you can have actual video documentation of findings that can be followed over a period of time which can help in diagnosis and treatment decisions,” she said.
How Are Ear Infections Diagnosed?
If you or your child has an earache that is accompanied (in some cases) by a stuffy or runny nose and a sore throat and fever, it is likely that the ear pain is due to an ear infection.
Your doctor will examine the eardrum with an instrument called an otoscope for signs of infection - not an easy task if the patient is a fussy infant. The doctor may also check for blockage or filling of the middle ear using a pneumatic otoscope, which blows a little air at the eardrum. This air should cause the eardrum to move a little back and forth. If fluid is present, the eardrum will not move as readily.
Another test for ear infections is tympanometry, which uses sound and air pressure to check for fluid in the middle ear. If needed, an audiologist will perform a hearing test to determine if there is hearing loss.
On rare occasions, when the person is quite ill, a doctor may make an opening in the eardrum, draw out a sample of fluid from the middle ear to culture the sample in a lab. This more extreme measure is usually used only for serious or particularly stubborn infections.
Parents also were very receptive to obtaining images of their child’s ear remotely, or from their home, and transmitting them for diagnosis, said Dr. Rappaport.
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The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.
Ear infection or inflammation (otitis media) facts
Otitis media (ear infection or inflammation) is the most common childhood condition for which antibiotics are prescribed.
Otitis media features fever, ear pain, and a feeling of fullness in the ear; as well as fussiness and feeding problems in young children.
Otitis media is usually an infection and/or inflammation of the middle ear.
Ear infection or inflammation causes fluid buildup in the middle ear.
A cold or other respiratory infection can lead to ear infections or inflammation.
Exposure to other children’s colds as often occurs in daycare centers, raises the risk of contracting otitis media (ear infection or inflammation).
Bottlefeeding increases the risk of ear infection or inflammation in babies.
Middle ear pus causes pain and temporary hearing loss.
Rupture of the eardrum allows the pus to drain into the ear canal.
Otitis media (ear infection or inflammation) is treated with observation, antibiotics, or ear tubes.
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Debbie Jacobson
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American Academy of Pediatrics