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Digital Image Enhancement Improves Sensitivity of Cholesteatoma Detection During Endoscopic Ear Surgery
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  • Talisa Ragonesi,
  • Laura Niederhauser,
  • Ignacio Fernandez,
  • Giulia Molinari,
  • Marco Caversaccio,
  • Livio Presutti,
  • Lukas Anschuetz
Talisa Ragonesi
Inselspital Universitatsspital Bern

Corresponding Author:[email protected]

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Laura Niederhauser
Inselspital University Hospital Bern
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Ignacio Fernandez
IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi
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Giulia Molinari
IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi
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Marco Caversaccio
Inselspital Universitatsspital Bern
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Livio Presutti
Università di Bologna
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Lukas Anschuetz
Inselspital University Hospital Bern
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Abstract

Objective: This study evaluates the benefits and limitations of selected modalities of digital image enhancement in detection of cholesteatoma remnants during endoscopic ear surgery (EES) and compares their usefulness in recognizing residual disease. Study Design: Cross-sectional study Setting: Tertiary referral hospital Methods: A total of 10 questionnaires of 18 intraoperative pictures with equal numbers of cholesteatoma and non-cholesteatoma images, each presented in three different image enhancing modalities (clara, spectra A, spectra B), were generated. Fifty-one experienced ear surgeons participated in the survey and were randomly assigned to a questionnaire and completed it at two time points. The experts were asked to rate for each picture whether cholesteatoma was present or not. Results Clara showed the highest accuracy in cholesteatoma detection, followed by spectra A and lastly spectra B. In contrast, spectra B showed the highest sensitivity and clara the highest specificity, while spectra A was placed in the middle for both values. Using the spectra B modality, most responses agreed across the two time points,. Ear surgeons assessed the usefulness, as well as preference among image modalities in the following order: clara, spectra B, spectra A. Conclusion The suitability of image enhancement techniques for application in EES could be shown. Clara can be considered the state-of-art technique throughout the procedure and has subjectively been evaluated best by surgeons. Due to its high sensitivity, spectra B is recommended regarding the final check after resection to prevent cholesteatoma residuals.
29 Mar 2022Submitted to Clinical Otolaryngology
19 Apr 2022Submission Checks Completed
19 Apr 2022Assigned to Editor
06 May 2022Reviewer(s) Assigned
30 May 2022Review(s) Completed, Editorial Evaluation Pending
12 Jun 2022Editorial Decision: Revise Major
29 Jul 20221st Revision Received
21 Aug 2022Submission Checks Completed
21 Aug 2022Assigned to Editor
11 Sep 2022Reviewer(s) Assigned
05 Dec 2022Review(s) Completed, Editorial Evaluation Pending
10 Dec 2022Editorial Decision: Revise Minor
31 Dec 20222nd Revision Received
10 Jan 2023Submission Checks Completed
10 Jan 2023Assigned to Editor
23 Jan 2023Review(s) Completed, Editorial Evaluation Pending
05 Feb 2023Editorial Decision: Revise Minor
22 Feb 20233rd Revision Received
23 Feb 2023Submission Checks Completed
23 Feb 2023Assigned to Editor
01 Mar 2023Review(s) Completed, Editorial Evaluation Pending
05 Mar 2023Editorial Decision: Accept