ReelDx Ear Case Study No. 2

Hear it here. Our second case study from ReelDx is in!

If you missed Case Study No. 1, you can view it here.

The Patient

A 9-month-old girl with a cough, fussy and is not eating or drinking. She was seen by providers the day before but was brought back into the Emergency Department because her symptoms persisted. The patient is on day 1 of a course of Amoxicillin.

The Work Up

Dr. Spiro from ReelDx took the patient’s history, conducted a physical exam, and then used the CellScope Oto for the otoscopic exam.

The Diagnosis

Acute Otitis Media (AOM), Otitis Media

What We Learned

An AOM can be challenging to diagnose. Is is suggested that providers follow the diagnosis guidelines recommended by the American Academy of Pediatrics. The wait- and-see prescription can be used in some cases and is accepted by families.  Since this patient was already on a course of antibiotics, Dr. Spiro recommended to continue the treatment and use Ibuprofen for pain as needed. Dr. Spiro cautions against switching antimicrobials because frequent changes can increase the likelihood of an adverse reaction, like a rash or diarrhea.

The patient’s right ear captured by the Oto. The patient was diagnosed with AOM.

The patient’s right ear captured by the Oto. The patient was diagnosed with Acute Otitis Media.

Check out both ear videos and full case write up on the ReelDx library.

Keep those case studies coming, Dr. Spiro!

CellScope Pioneers in the Lead!

We think all of our CellScope Pioneers are amazing! Each week Pioneers aim to log at least 25 ear exams with the Oto, but some super Pioneers far exceed this number.

We thought it would be great to find out who was on that super Pioneer list. From our dashboard we pulled together a list of the Pioneers that logged the most exams last week. We were blown away to find that in one week, these 12 pioneers logged close to 500 exams!!

Leader Board

1. Neil Rebbe (St. Louis, MO)
2. Anne Carter (South Pasadena, FL)
3. Sloane Sevran (Encino, CA)
4. Jennifer Moore (Norwalk, CT)
5. Charlotte Sloan (Myrtle Beach, SC)
6. Christopher McCarthy (Spartanburg, SC)
7. Darrin Cottle (Tooele, UT)
8. Melinda Amosu (Newnan, GA)
9. Jesse Hackell (Pomona, NY)
10. Brian Policano (Clarksburg, WV)
11. Marco Alcala  (Wexford, PA)
12. Donald Gronbeck (Grove City, OH)

Who will be on the leader board next week? Will you make the cut?

Interested in using the Oto in your practice? Find out how to become a Pioneer here.

Pioneer Sticker

“Can he hear through that tube?” And other important ear tube questions.

According to the National Center for Health Statistics, each year almost 670,000 ear tube surgeries are performed on children under 15 years old. This makes it the most common outpatient surgery for children in the U.S. So, as many parents often ask, what are ear tubes for?

Ear tubes provide ventilation and drainage of fluid build up in the middle ear by providing a small passageway through the eardrum, or tympanic membrane. No bigger than a nail head, ear tubes are usually tiny, hollow plastic parts. The illustration below depicts the size, shape and location of an ear tube. 

Photo Credit: Rosenfeld RM. A Parent's Guide to Ear Tubes. Hamilton: BC Decker Inc., 2005.

Photo Credit: Rosenfeld RM. A Parent’s Guide to Ear Tubes. Hamilton: BC Decker Inc., 2005.

We were curious about all the colorful ear tubes the Oto was capturing, so we asked Dr. Rashleigh to answer some of our questions. Dr. Stephen Rashleigh is an Otolaryngologist at the Ear, Nose and Throat Associates of Savannah and a CellScope Pioneer.

Q: When and why are ear tubes used?

Dr. Rashleigh: Tubes are placed for two main reasons: 

1) Chronic recurrent ear infections.  This is most common among children and has a high success rate in decreasing the number of infections.  If the patient gets a subsequent infection with the tubes in place, it can be treated with topical antibiotic ear drops, without taking antibiotics by mouth. 

2) Persistent middle ear effusion (or fluid in the middle ear) with hearing loss that is present over 3 months.

Q: How long are tubes needed for?

Dr. Rashleigh: They typically stay in place for 12-18 months.  Most children who get ear tubes only need this once.

Q: What are the risks involved?

Dr. Rashleigh: The risks of tubes include: persistent ear infections, tympanic membrane perforation when the tube falls out, and need for tube removal if it never falls out.

Q: What impact do they have on hearing?

Dr. Rashleigh: The tubes themselves do not cause any loss of hearing.

Q: Do tubes prevent you from swimming?

Dr. Rashleigh: Most people can bathe and swim with these tubes.

Dr. Rashleigh captured these two great images of ear tubes using his CellScope Oto last month.

The right ear of a patient #1 with Eustachian tube dysfunction.

The right ear of a patient #1 with Eustachian tube dysfunction.

Patient #1 (above) is a 32-year-old patient who recently had an ear tube put in. He had a history of chronic ear pressure on the right side and frequent fluid build up in the middle ear. Whenever he flew in an airplane this patient experienced ear pain, which could temporarily be relieved by auto-insufflating (“popping”) his ears. He was diagnosed with Eustachian tube dysfunction and his symptoms resolved with placement of this ear tube. 

Patient #2: Left ear image of a patient with chronic Eustachian tube dysfunction.

Patient #2: Left ear image of a patient with chronic Eustachian tube dysfunction.

Patient #2 (above) is an 85-year-old patient who has chronic Eustachian tube dysfunction. The picture above was taken after a replacement tube was put in place. The previous tube had fallen out after he developed an ear infection.

Thanks for sharing, Dr. Rashleigh!

CellScope Pioneers Forging New Territory Across the U.S.

Cell·Scope Pi·o·neer 
n. A clinician and iPhone 5 user eager to use the CellScope Oto and log a minimum of 25 ear exams per week.

There are now hundreds of CellScope Pioneer clinicians spread across the United States. They are working hard and wowing patients with the CellScope Oto. In less than eight weeks, the Pioneers have logged over 15,000 ear exams!

Our Pioneers are located all across the country. Just take a look at the Pioneer map below! The largest population of Pioneers are located in California, followed by Florida, New York, and Pennsylvania. They range in specialties from Primary Care, Audiology, to Emergency Medicine and ENT.

Pioneers Across the U.S. Each color represents a different specialty.

CellScope Pioneers across the U.S. Each color represents a different specialty.

You may notice that we are currently experiencing a Pioneer desert in the Dakotas (North and South), Wyoming, and Alaska. Know a good physician in those states? Let them, and any other great clinicians you know that we are actively recruiting Pioneers.

The CellScope Pioneer program is simple: licensed clinicians commit to logging a minimum of 25 exams (with diagnosis) per week into the Oto system. Not only do Pioneers get exclusive early access to the Oto, but their voices are listened to and will help shape improvements to the Oto system.

Want to become a CellScope Pioneer? Sign up now!

The Oto at Home: Tasha’s Story

Tasha of Born with Cholesteatoma

Tasha of Born with Cholesteatoma

Meet Tasha, she’s a mom of two and an early fan of the CellScope Oto. In May 2012, Tasha’s youngest daughter was diagnosed with a rare condition called congenital cholesteatoma. Cholesteatoma is a condition, either congenital or acquired, that causes abnormal growth of skin in the middle ear, behind the eardrum. The growth while not cancerous can damage the bones in the ear and result in permanent hearing loss.

A comparison between a normal ear versus an ear with cholesteatoma.

A comparison between a normal ear versus an ear with cholesteatoma. Image credit: http://dxline.info

After her daughter’s diagnosis, Tasha became frustrated at the lack of resources and information available about young children with cholesteatoma since most websites focused on older children and adults. This inspired Tasha to start her website and blog, Born With Cholesteatoma, which exists to provide a resource and meeting place for parents of children with cholesteatoma.

While the Oto was still in development, Tasha contacted us hoping to try it for herself. Even though the Oto wasn’t ready yet, we knew we had to get her an Oto since it was designed with parents like Tasha in mind.  In August of 2013, we reconnected with Tasha to see if she wanted to participate in a home test; she happily obliged.

Tasha has since chronicled her experience with the CellScope Oto in a three-part blog series. In Part 1, Tasha shares the backstory and her first impressions of the Oto prototype. The story gets exciting in Part 2, as Tasha begins frequently monitoring what appears to be a blocked ear tube in her youngest daughter’s ears. Tasha heads to the doctor’s office with her daughter in Part 3. Using photos from the Oto, she was able to avoid the common problem of trying to explain what something used to look like to her healthcare providers.

“I loved having the CellScope,” gushed Tasha. Several doctor visits, many Oto ear exams, and one resolved ear infection later Tasha writes, “Just the opportunity alone to catalog my daughter’s ears on an ongoing basis was/would be of incredible value to me, because I was able to show the images to her health professionals.”

Tasha, thanks for sharing! We are so glad we were able to share the Oto with you.

Head over to Tasha’s blog to read the full story.

CellScope Oto travels to Kenya

Recently a CellScope Oto prototype headed to East Africa in the hands of Dr. Michael Scahill, MD, MBA where it made its debut at a Jacaranda Health clinic in Nairobi, Kenya.

Dr. Mike Scahill, a third-year resident at UCSF and pediatric economist at Jacaranda Health, found the Oto so compelling he asked if he could take it with him to Kenya. “Tapping innovative technologies like CellScope is key to our strategy,” says Dr. Scahill, who is responsible for building out the pediatric services at Jacaranda Health.

Their mission: to bring affordable and quality maternal and newborn health for low-income women in East Africa. Jacaranda Health’s network of private maternity clinics uses innovation to provide a truly sustainable business model for delivering high-quality, patient-centered care in resource-poor settings.

While at the Jacaranda Health clinic, Dr. Scahill had the opportunity to use the Oto prototype to perform ear exams on the infants coming in for a check up.

Dr. Scahill examines an infant's ears using the Oto prototype.

Dr. Scahill examines an infant’s ear using the Oto prototype.

Dr. Scahill getting excellent images of the ear using the Oto prototype.

The Oto prototype in action.

Thank you, Dr. Scahill for introducing the Oto to the families Jacaranda Health serves!

You can learn more about Jacaranda Health and their great work at http://jacarandahealth.org/

ReelDx Ear Case Study No. 1

REEL Dx Dark BlueLast week we announced a new partnership with ReelDx which allows us to share cases that utilize the CellScope Oto with our readers. This week we are excited to present our first public learning case from the ReelDx platform!

The Patient

A 9-year-old girl with a runny nose, cough, and right ear pain.

The Work Up

Dr. Spiro from ReelDx took the patient’s history, conducted a physical exam, and then used the CellScope Oto for the otoscopic exam.

The Diagnosis

Eustachian tube dysfunction (ETD)

What We Learned

An ETD occurs when the Eustachian tube is blocked and often results in dull hearing. It is a temporary condition that lasts roughly a week and usually occurs during or after an upper respiratory infection. Typically, it resolves on its own but nasal steroids or antihistamines can be prescribed in more severe cases. In diagnosing an ETD, a clear otoscopic exam, like the one shown below, is critical!

A photo of the right Tympanic Membrane captured by the Oto.

A photo of the patient’s right Tympanic Membrane captured by the Oto.

Check out both ear videos and full case write up on the ReelDx blog.