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At least 73 records · Page 4Linked to original sources
PubMed1996

Preoperative diagnosis of intratemporal facial nerve tumor: high-resolution CT and otoscopic findings in 4 cases.

Four cases of facial nerve tumor were treated in our clinic during the past 16 years, one of which was a recurrence 12 years after the resection. Another case presented with relapsing facial palsy of sudden onset. The others presented with slowly progressive facial palsy. In each of the four cases, the horizontal and vertical portions were included in the tumor extension, and a mass was revealed in the posterior tympanic cavity by use of otoscopy. High-resolution CT, performed in all but the earliest case, proved to be the most valuable diagnostic tool, indicating the anatomical correlation of the tumor with the facial canal. With the diagnosis preoperatively established, facial reanimation procedure could be applied immediately after the tumor resection except in the recurrent case.

Cranial Nerve Neoplasms↗
PubMed1995

[From otoscope to ophthalmoscope and back. The interwoven history of their invention and introduction into medical practice. Pictures from the history of otorhinolaryngology, illustrated by instruments from the collection of the Ingolstadt German Medical History Museum].

Friedrich Hofmann, medical officer in Burgsteinfurt, Westphalia, Germany, in 1841 described a concave mirror with a central aperture in it as the ideal instrument that allowed reflecting and focussing light into the external auditory canal and simultaneously inspecting the tympanic membrane without obstructing either the light or the view. He recommended his device also for the inspection of other concealed regions of the body. His invention was referred to by Martell Frank in his textbook of otology in 1845, but otherwise attracted no attention. Hermann Helmholtz, physiologist in Königsberg, East Prussia, devised his ophthalmoscope in 1850-51 in order to study the phenomenon of glowing eyes. With this instrument he was the first to see the retina of a living human. As means of illumination he used small panes of glass similar to cover-glasses which were introduced into the common visual axis of the observer and the subject at such an angle that light from a lamp was reflected into the subject's eye while the observer inspected the subject's retina through the glass and an appropriate lens. He recommended this type of illumination also for otoscopy. His invention was at once acclaimed throughout the world and opened completely new opportunities in ophthalmology. The slanting panes of glass, however, were not the ideal solution for illumination. It was only one year later that Ruete in Göttingen replaced them with a concave mirror with a central aperture, and there is every indication that Frank's report on Hofmann's mirror had suggested this technique to him. During the following two years quite a number of other modifications of the ophthalmoscope were constructed, all of them using the concave mirror with a central aperture, which soon became synonymous with the ophthalmoscope as such. Von Tröltsch, otologist and ophthalmologist in Würzburg, presented a concave mirror with a central aperture for otoscopy in Paris in 1855-56. His instrument was obviously derived from the already well known ophthalmoscope by adapting the diameter and focal distance to this special application. His primary concern was to use daylight instead of artificial light for otoscopy. Von Tröltsch did not know Hofmann's publication, but later did not hesitate to acknowledge Hofmann's priority. It was von Tröltsch who popularized the concave reflector with a central aperture as the instrument of choice in otoscopy, and subsequently also for rhinoscopy and laryngoscopy. Further modifications were devised to have the hands free for operations. Thus the reflector was fixed to the forehead by strap and buckle or a vulcanite band, or it was provided with a handle that was to be held between the teeth, or it was attached to a spectacle frame. The details of this interwoven history are related and highlighted by numerous quotations and historical illustrations.

Ear↗
PubMed1996

Advances in the development of the interferometric otoscope.

Present measurement techniques for middle ear function have inherent limitations because they are either spatially insensitive (acoustic immittance) or descriptive and qualitative in nature (otoscopy). By integrating advances in electrooptic technology (fiber optics, miniature diode lasers, solid-state detector arrays) and digital processing, further advances are possible. On the basis of measurements taken with electronic speckle-pattern interferometry on human temporal bones and models, we demonstrate quantitative static and dynamic vibration/displacement characteristics of the tympanic membrane with high spatial resolution. Our presentation emphasizes advantages of optically based methods and demonstrates computerized signal processing capable of fringe localization, enhancement, and counting. Miniaturization and real-time digital image processing in the clinical setting is the goal of this research.

Humans↗
PubMed1995

Is otoscopy reliable? A structured teaching method to improve otoscopic accuracy in trainees.

Otoscopy is an important skill for primary care physicians and otologists. Until now, training has been by repeated exposure to patients with ear disease. Structured instruction in how to assess an ear has not previously been reported. Not-diseased ears and those with varying types of chronic (suppurative) otitis media were chosen to be photographed as this is an important condition to be able to diagnose and in which pneumatic otoscopy has no role. Two sets of 30 slides of equal difficulty were shown to 10 trainees, one before and one after structured teaching. The overall error rate fell from 44 to 21% (P < 0.001). Most importantly, the error rate in assessing ear activity fell from 35 to 17% (P < 0.05). In conclusion, a structured approach to otoscopy has been shown to improve the diagnostic ability of trainess tested with photographs of ears with chronic otitis media. Such a teaching approach is likely to be equally beneficial to other otological conditions and to live otoscopy.

Diagnostic Errors↗
PubMed2002

The otoscope.

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Equipment Design↗