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Nwosu O, Suresh K, Knoll R, Lee DJ, Crowson MG. A Proof-of-Concept Computer Vision Approach for Measurement of Tympanic Membrane Perforations. Laryngoscope 2024; 134:2906-2911. [PMID: 38214334 DOI: 10.1002/lary.31270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/18/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE Size, an important characteristic of a tympanic membrane perforation (TMP), is commonly assessed with gross estimation via visual inspection, a practice which is prone to inaccuracy. Herein, we demonstrate feasibility of a proof-of-concept computer vision model for estimating TMP size in a small set of perforations. METHODS An open-source deep learning architecture was used to train a model to segment and calculate the area of a perforation and the visualized tympanic membrane (TM) in a set of endoscopic images of mostly anterior and relatively small TMPs. The model then computed relative TMP size by calculating the ratio of perforation area to TM area. Model performance on the test dataset was compared to ground-truth manual annotations. In a validation survey, otolaryngologists were tasked with estimating the size of TMPs from the test dataset. The primary outcome was the average absolute error of model size predictions and clinician estimates compared to sizes determined by ground-truth manual annotations. RESULTS The model's average absolute error for size predictions was a 0.8% overestimation for all test perforations. Conversely, among the 38 survey respondents, the average clinician error was a 11.0% overestimation (95% CI, 5.2-16.7%, p = 0.003). CONCLUSIONS In a small sample of TMPs, we demonstrated a computer vision approach for estimating TMP size is feasible. Further validation studies must be done with significantly larger and more heterogenous datasets. LEVEL OF EVIDENCE N/A Laryngoscope, 134:2906-2911, 2024.
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Affiliation(s)
- Obinna Nwosu
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Krish Suresh
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Renata Knoll
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel J Lee
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Matthew G Crowson
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear, Boston, Massachusetts, USA
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
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Svistushkin M, Kotova S, Zolotova A, Fayzullin A, Antoshin A, Serejnikova N, Shekhter A, Voloshin S, Giliazova A, Istranova E, Nikiforova G, Khlytina A, Shevchik E, Nikiforova A, Selezneva L, Shpichka A, Timashev PS. Collagen Matrix to Restore the Tympanic Membrane: Developing a Novel Platform to Treat Perforations. Polymers (Basel) 2024; 16:248. [PMID: 38257047 PMCID: PMC10820519 DOI: 10.3390/polym16020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/25/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Modern otology faces challenges in treating tympanic membrane (TM) perforations. Instead of surgical intervention, alternative treatments using biomaterials are emerging. Recently, we developed a robust collagen membrane using semipermeable barrier-assisted electrophoretic deposition (SBA-EPD). In this study, a collagen graft shaped like a sponge through SBA-EPD was used to treat acute and chronic TM perforations in a chinchilla model. A total of 24 ears from 12 adult male chinchillas were used in the study. They were organized into four groups. The first two groups had acute TM perforations and the last two had chronic TM perforations. We used the first and third groups as controls, meaning they did not receive the implant treatment. The second and fourth groups, however, were treated with the collagen graft implant. Otoscopic assessments were conducted on days 14 and 35, with histological evaluations and TM vibrational studies performed on day 35. The groups treated with the collagen graft showed fewer inflammatory changes, improved structural recovery, and nearly normal TM vibrational properties compared to the controls. The porous collagen scaffold successfully enhanced TM regeneration, showing high biocompatibility and biodegradation potential. These findings could pave the way for clinical trials and present a new approach for treating TM perforations.
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Affiliation(s)
- Mikhail Svistushkin
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Svetlana Kotova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Anna Zolotova
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Alexey Fayzullin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Artem Antoshin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Natalia Serejnikova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Anatoly Shekhter
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Sergei Voloshin
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Aliia Giliazova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Elena Istranova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Galina Nikiforova
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Arina Khlytina
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Elena Shevchik
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Anna Nikiforova
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Liliya Selezneva
- Department for ENT Diseases, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (M.S.); (A.Z.); (G.N.); (A.K.); (E.S.); (A.N.); (L.S.)
| | - Anastasia Shpichka
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
| | - Peter S. Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya St., Moscow 119991, Russia; (S.K.); (A.F.); (A.A.); (N.S.); (A.S.); (S.V.); (A.G.); (E.I.); (P.S.T.)
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