Few-Shot Wideband Tympanometry Classification in Otosclerosis via Domain Adaptation with Gaussian Processes

Otosclerosis is a common middle ear disease that requires a combination of examinations for its diagnosis in routine. In a previous study, we showed that this disease could be potentially diagnosed by wideband tympanometry (WBT) coupled with a convolutional neural network (CNN) in a rapid and non-invasive manner. We showed that deep transfer learning with data augmentation could be applied successfully on such a task. However, the involved synthetic and realistic data have a significant discrepancy that impedes the performance of transfer learning. To address this issue, a Gaussian processes-guided domain adaptation (GPGDA) algorithm was developed. It leveraged both the loss about the distribution distance calculated by the Gaussian processes and the loss of conventional cross entropy during the transferring. On a WBT dataset including 80 otosclerosis and 55 control samples, it achieved an area-under-the-curve of 97.9±1.1 percent after receiver operating characteristic analysis and an F1-score of 95.7±0.9 percent that were superior to the baseline methods (r=10, p<0.05, ANOVA). To understand the algorithm’s behavior, the role of each component in the GPGDA was experimentally explored on the dataset. In conclusion, our GPGDA algorithm appears to be an effective tool to enhance CNN-based WBT classification in otosclerosis using just a limited number of realistic data samples.

Tuberculosis otitis media: problem relevance

Aim: currently clarification of the course characteristics, diagnosis and treatment principles of tuberculosis otitis media. Materials and methods: The study included 6 cases (8 ears) of tuberculosis otitis media and mastoid process from 2015 to 2020. Clinical, radiological, bacteriological, pathomorphological studies were used for diagnostics. Results: Primary localization of tuberculosis in the middle ear was found in 2 patients. In 4 patients tuberculosis middle otitis associated with lung affection. The disease manifested in the form of purulent perforated otitis media with a polymorphic otoscopic picture in all examined patients. The terms of the diagnosis were from 6 months to 1.5 years since the onset of the disease. This indicates the complexity of diagnosing the tuberculous etiology of the middle ear disease.

The Role of Otoscopy in the Diagnosis of Rare Diseases in Pediatrics. Congenital Middle Ear Cholesteatoma in the Child: Clinical Case

The clinical recommendations “Acute respiratory viral infection (ARVI) in children" indicate that otoscopy should be a part of routine pediatric examination of each patient along with auscultation, percussion, etc. Nowadays, there are no legal regulations on which specialists can perform otoscopy. Thus, there is significant pediatricians’ interest in otoscopy, especially in diagnosis of acute otitis media (AOM) during primary examination for timely antibacterial management. Moreover, pediatricians could reveal such rare and very aggressive middle ear disease as cholesteatoma, its early diagnosis can prevent the development of any complications and determines the range and quality of rehabilitation actions.

Challenges in managing complex chronic middle ear disease: MERF experience

<p><strong>Background: </strong>Chronic otitis media is one of the commonest conditions managed in otolaryngology practice. In developing countries such as India, advanced disease presentation is often seen mostly owing to lack of awareness of the disease and its potential complications, long distance between the patient’s home and the treatment centre, causing delay in treatment. Surgical management is the mainstay of treatment of chronic otitis media.</p><p><strong>Methods: </strong>The aim of this study was to retrospectively analyze the patients with complex chronic middle ear disease, who underwent tympanomastoid surgery. Forty-seven<strong> </strong>patients (4.9%) out of a total of 968 patients with chronic otitis media presented with complex advanced disease and challenging intra-operative situations at our tertiary referral centre between January 2016 to December 2020. The extent of disease, associated complications, challenges in surgical management, and the eventual outcomes were studied in detail.</p><p><strong>Results: </strong>Among<strong> </strong>these forty-seven<strong> </strong>patients, there were 24 males and 23 females. Of the 47 patients, 8 were children (17%). Extensive cholesteatoma causing facial palsy, labyrinthine fistula, dural involvement, internal auditory meatus involvement, extensive granulations extending into the inner ear through the oval or round window, extensive tympanosclerosis was noted in these patients. All patients underwent surgical management, and achieved satisfactory outcomes.</p><p><strong>Conclusions: </strong>Advanced chronic otitis media has the potential to pose various challenges during tympanomastoid surgery. Appropriate planning for surgery aiming at complete disease clearance, meticulous after-care and long-term surveillance result in favorable outcomes.</p>

Disability from chronic ear disease in Nepal assessed using the World Health Organization Disability Assessment Schedule 2.0 instrument

Objective Globally, South Asia has the highest proportion of disabling hearing loss. There is a paucity of data exploring the associated hearing loss and disability caused by chronic middle-ear disease in South Asia in the setting of surgical outreach. This study aimed to measure disability using the World Health Organization Disability Assessment Schedule 2.0 in patients undergoing ear surgery for chronic middle-ear disease in an ear hospital in Nepal. Method The World Health Organization Disability Assessment Schedule 2.0 was translated into Nepali and administered by interview to patients before ear surgery, and results were correlated with pre-operative audiograms. Results Out of a total of 106 patients with a mean age of 23 years, the mean World Health Organization Disability Assessment Schedule 2.0 score was 17.7, and the highest domain scores were for domain 6 ‘participation in society’ at a score of 34. There was a positive correlation of World Health Organization Disability Assessment Schedule 2 score with hearing level (r = 0.46). Conclusion Patients with ear disease in Nepal have had their disability measured using the World Health Organization Disability Assessment Schedule 2.0. Our study demonstrated a correlation between impaired hearing and disability in a surgical outreach context, which was an expected but not previously reported finding.

Adenoidectomy for middle ear disease in cleft palate children: a systematic review

Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.