Otolaryngology - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 19
-
ItemEar, nose and throat surgery: All you need to know about the surgical approach to the management of middle-ear effusions in Australian Indigenous and non-Indigenous children(WILEY, 2017-11)Otitis media (OM) is a common condition in Australia. It represents a spectrum of diseases from otitis media with effusion (OME) to chronic suppurative otitis media. For all the OM diagnoses, Australian Indigenous children have higher rates of early onset, severe and persistent disease. OME is the most common form of OM and often occurs after an upper respiratory tract infection. It can be difficult to diagnose (and often goes unrecognised). Hearing loss is the most important complication. The middle-ear effusion impedes the movement of the tympanic membrane and causes a conductive hearing loss of around 25 dB. Around 20% will have a hearing loss exceeding 35 dB. Children with early onset, persistent, bilateral OME and hearing loss (or speech delay) are most likely to benefit from interventions. However, the impact of all the effective treatment options is modest. Giving advice about effective communication strategies for young children is always appropriate. The best evidence from randomised trials supports not using antihistamines and/or decongestants, considering a trial of antibiotics and referral for tympanostomy tubes. Despite the availability of evidence-based guidelines, giving advice about treatment is a challenge because recommendations vary according to condition, age, risk of complications and parental preference. While most children with OME can be effectively managed in primary care, we need to get children who meet the criteria for simple ear, nose and throat procedures that improve hearing on to ear, nose and throat surgery waiting lists. Long delays in hearing support may contribute to life-long social and economic disadvantage.
-
ItemEffect of cochlear implantation on middle ear function: A three-month prospective study(WILEY, 2018-05)OBJECTIVES/HYPOTHESIS: To determine if cochlear implantation has a delayed effect on the middle ear conductive hearing mechanism by measuring laser Doppler vibrometry (LDV) of the tympanic membrane (TM) in both implanted and contralateral control ears preoperatively and 3 months postoperatively, and then comparing the relative change in LDV outcome measures between implanted and control ears. STUDY DESIGN: Prospective cohort study. METHODS: Eleven preoperative adult unilateral cochlear implant recipients in previously unoperated ears with normal anatomy and aerated temporal bones were included in this study. The magnitude and phase angle of umbo velocity transfer function in response to air- conduction (AC) stimulus, and the magnitude of umbo velocity in response to bone- conduction (BC) stimulus were measured in the implant ear and the contralateral control ear preoperatively and 3 months postoperatively and compared. RESULTS: No significant changes in the magnitude or phase angle of TM velocity in response to either AC or BC stimulus were observed in the implanted ear relative to the contralateral control ear 3 months following cochlear implantation. CONCLUSIONS: From the results of LDV measurements, it can be said that cochlear implantation has no significant delayed effect on the middle ear conductive mechanism. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:1207-1212, 2018.
-
ItemStreet Sign Recognition Using Histogram of Oriented Gradients and Artificial Neural Networks(MDPI, 2019-04)Street sign identification is an important problem in applications such as autonomous vehicle navigation and aids for individuals with vision impairments. It can be especially useful in instances where navigation techniques such as global positioning system (GPS) are not available. In this paper, we present a method of detection and interpretation of Malaysian street signs using image processing and machine learning techniques. First, we eliminate the background from an image to segment the region of interest (i.e., the street sign). Then, we extract the text from the segmented image and classify it. Finally, we present the identified text to the user as a voice notification. We also show through experimental results that the system performs well in real-time with a high level of accuracy. To this end, we use a database of Malaysian street sign images captured through an on-board camera.
-
Item
-
ItemRegion-Specific Automated Feedback in Temporal Bone Surgery Simulation(IEEE, 2015)The use of virtual reality simulators for surgical training has gained popularity in recent years, with an ever increasing body of evidence supporting the benefits and validity of simulation-based training. However, a crucial component of effective skill acquisition has not been adequately addressed, namely the provision of timely performance feedback. The utility of a surgical simulator is limited if it still requires the presence of experts to guide trainees. Automated feedback that emulates the advise provided by experts is necessary to facilitate independent learning. We propose an automated system that provides region-specific feedback on surgical technique within a temporal bone surgery simulator. The design of this system allows easy transfer of feedback models to multiple temporal bone specimens in the simulator. The system was validated by an expert otologist and was found to provide highly accurate and timely feedback.
-
ItemPresentation of automated procedural guidance in surgical simulation: results of two randomised controlled trials(Cambridge University Press, 2018-03)OBJECTIVE: To investigate the effectiveness and usability of automated procedural guidance during virtual temporal bone surgery. METHODS: Two randomised controlled trials were performed to evaluate the effectiveness, for medical students, of two presentation modalities of automated real-time procedural guidance in virtual reality simulation: full and step-by-step visual presentation of drillable areas. Presentation modality effectiveness was determined through a comparison of participants' dissection quality, evaluated by a blinded otologist, using a validated assessment scale. RESULTS: While the provision of automated guidance on procedure improved performance (full presentation, p = 0.03; step-by-step presentation, p < 0.001), usage of the two different presentation modalities was vastly different (full presentation, 3.73 per cent; step-by-step presentation, 60.40 per cent). CONCLUSION: Automated procedural guidance in virtual temporal bone surgery is effective in improving trainee performance. Step-by-step presentation of procedural guidance was engaging, and therefore more likely to be used by the participants.
-
ItemA rotation and translation invariant method for 3D organ image classification using deep convolutional neural networks(PEERJ INC, 2019-03-04)Three-dimensional (3D) medical image classification is useful in applications such as disease diagnosis and content-based medical image retrieval. It is a challenging task due to several reasons. First, image intensity values are vastly different depending on the image modality. Second, intensity values within the same image modality may vary depending on the imaging machine and artifacts may also be introduced in the imaging process. Third, processing 3D data requires high computational power. In recent years, significant research has been conducted in the field of 3D medical image classification. However, most of these make assumptions about patient orientation and imaging direction to simplify the problem and/or work with the full 3D images. As such, they perform poorly when these assumptions are not met. In this paper, we propose a method of classification for 3D organ images that is rotation and translation invariant. To this end, we extract a representative two-dimensional (2D) slice along the plane of best symmetry from the 3D image. We then use this slice to represent the 3D image and use a 20-layer deep convolutional neural network (DCNN) to perform the classification task. We show experimentally, using multi-modal data, that our method is comparable to existing methods when the assumptions of patient orientation and viewing direction are met. Notably, it shows similarly high accuracy even when these assumptions are violated, where other methods fail. We also explore how this method can be used with other DCNN models as well as conventional classification approaches.
-
ItemNeurotrophin Gene Therapy for Sustained Neural Preservation after Deafness(PUBLIC LIBRARY SCIENCE, 2012-12-17)The cochlear implant provides auditory cues to profoundly deaf patients by electrically stimulating the residual spiral ganglion neurons. These neurons, however, undergo progressive degeneration after hearing loss, marked initially by peripheral fibre retraction and ultimately culminating in cell death. This research aims to use gene therapy techniques to both hold and reverse this degeneration by providing a sustained and localised source of neurotrophins to the deafened cochlea. Adenoviral vectors containing green fluorescent protein, with or without neurotrophin-3 and brain derived neurotrophic factor, were injected into the lower basal turn of scala media of guinea pigs ototoxically deafened one week prior to intervention. This single injection resulted in localised and sustained gene expression, principally in the supporting cells within the organ of Corti. Guinea pigs treated with adenoviral neurotrophin-gene therapy had greater neuronal survival compared to contralateral non-treated cochleae when examined at 7 and 11 weeks post injection. Moreover; there was evidence of directed peripheral fibre regrowth towards cells expressing neurotrophin genes after both treatment periods. These data suggest that neurotrophin-gene therapy can provide sustained protection of spiral ganglion neurons and peripheral fibres after hearing loss.
-
ItemPre-, Per- and Postoperative Factors Affecting Performance of Postlinguistically Deaf Adults Using Cochlear Implants: A New Conceptual Model over Time(PUBLIC LIBRARY SCIENCE, 2012-11-09)OBJECTIVE: To test the influence of multiple factors on cochlear implant (CI) speech performance in quiet and in noise for postlinguistically deaf adults, and to design a model of predicted auditory performance with a CI as a function of the significant factors. STUDY DESIGN: Retrospective multi-centre study. METHODS: Data from 2251 patients implanted since 2003 in 15 international centres were collected. Speech scores in quiet and in noise were converted into percentile ranks to remove differences between centres. The influence of 15 pre-, per- and postoperative factors, such as the duration of moderate hearing loss (mHL), the surgical approach (cochleostomy or round window approach), the angle of insertion, the percentage of active electrodes, and the brand of device were tested. The usual factors, duration of profound HL (pHL), age, etiology, duration of CI experience, that are already known to have an influence, were included in the statistical analyses. RESULTS: The significant factors were: the pure tone average threshold of the better ear, the brand of device, the percentage of active electrodes, the use of hearing aids (HAs) during the period of pHL, and the duration of mHL. CONCLUSIONS: A new model was designed showing a decrease of performance that started during the period of mHL, and became faster during the period of pHL. The use of bilateral HAs slowed down the related central reorganization that is the likely cause of the decreased performance.
-
ItemThe Construct Validity and Reliability of an Assessment Tool for Competency in Cochlear Implant Surgery(HINDAWI LTD, 2014)INTRODUCTION: We introduce a rating tool that objectively evaluates the skills of surgical trainees performing cochlear implant surgery. METHODS: Seven residents and seven experts performed cochlear implant surgery sessions from mastoidectomy to cochleostomy on a standardized virtual reality temporal bone. A total of twenty-eight assessment videos were recorded and two consultant otolaryngologists evaluated the performance of each participant using these videos. RESULTS: Interrater reliability was calculated using the intraclass correlation coefficient for both the global and checklist components of the assessment instrument. The overall agreement was high. The construct validity of this instrument was strongly supported by the significantly higher scores in the expert group for both components. CONCLUSION: Our results indicate that the proposed assessment tool for cochlear implant surgery is reliable, accurate, and easy to use. This instrument can thus be used to provide objective feedback on overall and task-specific competency in cochlear implantation.