Otitis media is one of the most common reasons for pediatrician visits, antibiotic prescription, and surgery in the pediatric population. Visible light pneumatic-otoscopy is considered the best currently available diagnostic tool for otitis media. However, it has various limitations e.g. the disposable speculum cannot create an adequate seal against the external auditory canal to obtain tympanic membrane movement. Also, lack of training for effective pneumatic-otoscopy for most clinicians is another factor. To overcome these limitations, we have recently developed an otoscope sensitive to shortwave infrared (SWIR) wavelengths of light. A SWIR otoscope could help identify middle-ear-effusions based on the strong light absorption by ear fluid. Due to a longer wavelength, light can penetrate deeper through tissue, enabling a better view behind the tympanic membrane. Here we present our preliminary findings on the feasibility of using video rate SWIR imaging in a pediatric population. A total of 74 ear video recordings were obtained in the study from 20 patients. There was an improvement in the ability to see through the tympanic membrane using the SWIR otoscope. Three patients with middle ear effusion, confirmed by pneumatic otoscopy, were all identified using both visible and SWIR otoscopy. The average contrast for visible otoscopy in the presence of middle ear effusion was 0.097 and for SWIR was 0.29. In tympanic membranes with myringosclerosis, neither technique was able to see through affected areas. However, the SWIR otoscope was able to see through dried blood, dried secretions and thin dry areas of cerumen overlying the tympanic membrane.
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