{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:07:44Z","timestamp":1793718464452,"version":"4.6.1"},"reference-count":69,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Otitis media, a common disease marked by the presence of fluid within the middle ear space, imparts a significant global health and economic burden. Identifying an effusion through the tympanic membrane is critical to diagnostic success but remains challenging due to the inherent limitations of visible light otoscopy and user interpretation. Here we describe a powerful diagnostic approach to otitis media utilizing advancements in otoscopy and machine learning. We developed an otoscope that visualizes middle ear structures and fluid in the shortwave infrared region, holding several advantages over traditional approaches. Images were captured in vivo and then processed by a novel machine learning based algorithm. The model predicts the presence of effusions with greater accuracy than current techniques, offering specificity and sensitivity over 90%. This platform has the potential to reduce costs and resources associated with otitis media, especially as improvements are made in shortwave imaging and machine learning.<\/jats:p>","DOI":"10.1038\/s41598-021-91736-9","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T06:04:25Z","timestamp":1623737065000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Shortwave infrared otoscopy for diagnosis of middle ear effusions: a machine-learning-based approach"],"prefix":"10.1038","volume":"11","author":[{"given":"Rustin G.","family":"Kashani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel C.","family":"M\u0142y\u0144czak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zarabanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Solis-Pazmino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Huland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iram N.","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surya P.","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulio A.","family":"Valdez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"91736_CR1","doi-asserted-by":"publisher","first-page":"16063","DOI":"10.1038\/nrdp.2016.63","volume":"2","author":"AGM Schilder","year":"2016","unstructured":"Schilder, A. G. M. et al. Otitis media. Nat. Rev. Dis. Primers. 2, 16063 (2016).","journal-title":"Nat. Rev. Dis. Primers."},{"key":"91736_CR2","doi-asserted-by":"publisher","first-page":"e36226","DOI":"10.1371\/journal.pone.0036226","volume":"7","author":"L Monasta","year":"2012","unstructured":"Monasta, L. Burden of disease caused by otitis media: Systematic review and global estimates. PLoS ONE. 7, e36226 (2012).","journal-title":"PLoS ONE."},{"key":"91736_CR3","doi-asserted-by":"publisher","first-page":"e964","DOI":"10.1542\/peds.2012-3488","volume":"131","author":"AS Lieberthal","year":"2013","unstructured":"Lieberthal, A. S. et al. The diagnosis and management of acute otitis media. Pediatrics 131, e964\u2013e999 (2013).","journal-title":"Pediatrics"},{"key":"91736_CR4","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1097\/MOP.0000000000000184","volume":"27","author":"J Nokso-Koivisto","year":"2015","unstructured":"Nokso-Koivisto, J., Marom, T. & Chonmaitree, T. Importance of viruses in acute otitis media. Curr. Opin. Pediatr. 27, 110\u2013115 (2015).","journal-title":"Curr. Opin. Pediatr."},{"key":"91736_CR5","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1086\/528685","volume":"46","author":"T Chonmaitree","year":"2008","unstructured":"Chonmaitree, T. et al. Viral upper respiratory tract infection and otitis media complication in young children. Clin. Infect. Dis. 46, 815\u2013823 (2008).","journal-title":"Clin. Infect. Dis."},{"key":"91736_CR6","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.1001\/jama.2010.1651","volume":"304","author":"TR Coker","year":"2010","unstructured":"Coker, T. R. et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: A systematic review. JAMA 304, 2161\u20132169 (2010).","journal-title":"JAMA"},{"key":"91736_CR7","doi-asserted-by":"publisher","first-page":"e0150949","DOI":"10.1371\/journal.pone.0150949","volume":"11","author":"CC Ngo","year":"2016","unstructured":"Ngo, C. C., Massa, H. M., Thornton, R. B. & Cripps, A. W. Predominant bacteria isolated from the middle ear fluid of children experiencing otitis media: A systematic review. PLoS ONE 11, e0150949 (2016).","journal-title":"PLoS ONE"},{"key":"91736_CR8","first-page":"1","volume":"18","author":"MJ Hutz","year":"2018","unstructured":"Hutz, M. J., Moore, D. M. & Hotaling, A. J. Neurological complications of acute and chronic otitis media. Neurol. Syst. Dis. 18, 1\u20137 (2018).","journal-title":"Neurol. Syst. Dis."},{"key":"91736_CR9","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1258\/0022215001905012","volume":"114","author":"U Osma","year":"2000","unstructured":"Osma, U., Cureoglu, S. & Hosgoglu, S. The complications of chronic otitis media: Report of 93 cases. J. Laryngol. Otol. 114, 97\u2013100 (2000).","journal-title":"J. Laryngol. Otol."},{"key":"91736_CR10","doi-asserted-by":"publisher","first-page":"2923","DOI":"10.1007\/s00405-013-2778-4","volume":"271","author":"J Sun","year":"2014","unstructured":"Sun, J. & Sun, J. Intracranial complications of chronic otitis media. Eur. Arch. Otorhinolaryngol. 271, 2923\u20132926 (2014).","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"91736_CR11","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1017\/S0022215100125095","volume":"107","author":"J Kangsanarak","year":"1993","unstructured":"Kangsanarak, J. et al. Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases. J. Laryngol. Otol. 107, 999\u20131004 (1993).","journal-title":"J. Laryngol. Otol."},{"key":"91736_CR12","doi-asserted-by":"publisher","first-page":"e20170125","DOI":"10.1542\/peds.2017-0125","volume":"139","author":"DW Steele","year":"2017","unstructured":"Steele, D. W. et al. Effectiveness of tympanostomy tubes for otitis media: A meta-analysis. Pediatrics 139, e20170125 (2017).","journal-title":"Pediatrics"},{"key":"91736_CR13","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1542\/peds.113.5.1451","volume":"113","author":"Subcommittee on Management of Acute Otitis Media","year":"2004","unstructured":"Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media. Pediatrics 113, 1451\u20131465 (2004).","journal-title":"Pediatrics"},{"key":"91736_CR14","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1177\/00034894880970S209","volume":"97","author":"JD Nelson","year":"1988","unstructured":"Nelson, J. D. Management of chronic suppurative otitis media: A survey of practicing pediatricians. Ann. Otol. Rhinol. Laryngol. 97, 26\u201328 (1988).","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"91736_CR15","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1542\/peds.112.3.510","volume":"112","author":"WS Jones","year":"2003","unstructured":"Jones, W. S. & Kaleida, P. H. How helpful is pneumatic otoscopy in improving diagnostic accuracy. Pediatrics 112, 510\u2013513 (2003).","journal-title":"Pediatrics"},{"key":"91736_CR16","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1542\/peds.112.6.1379","volume":"112","author":"GS Takata","year":"2003","unstructured":"Takata, G. S. et al. Evidence assessment of the accuracy of methods of diagnosing middle ear effusion in children with otitis media with effusion. Pediatrics 112, 1379\u20131387 (2003).","journal-title":"Pediatrics"},{"key":"91736_CR17","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1097\/00005537-200310000-00004","volume":"113","author":"RM Rosenfeld","year":"2003","unstructured":"Rosenfeld, R. M. & Kay, D. Natural history of untreated otitis media. Laryngoscope. 113, 1645\u20131657 (2003).","journal-title":"Laryngoscope."},{"key":"91736_CR18","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1007\/s10096-003-0981-8","volume":"22","author":"ME Pichichero","year":"2003","unstructured":"Pichichero, M. E. Diagnostic accuracy of otitis media and tympanocentesis skills assessment among pediatricians. Eur. J. Clin. Microbiol. Infect. Dis. 22, 519\u2013524 (2003).","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"91736_CR19","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1001\/archpedi.155.10.1137","volume":"155","author":"ME Pichichero","year":"2001","unstructured":"Pichichero, M. E. & Poole, M. D. Assessing diagnostic accuracy and tympanocentesis skills in the management of otitis media. Arch. Pediatr. Adolesc. Med. 155, 1137\u20131142 (2001).","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"91736_CR20","doi-asserted-by":"publisher","first-page":"e714","DOI":"10.1542\/peds.2008-2838","volume":"124","author":"PH Kaleida","year":"2009","unstructured":"Kaleida, P. H. et al. Mastering diagnostic skills: Enhancing proficiency in otitis media, a model for diagnostic skills training. Pediatrics 124, e714\u2013e720 (2009).","journal-title":"Pediatrics"},{"key":"91736_CR21","doi-asserted-by":"publisher","first-page":"109652","DOI":"10.1016\/j.ijporl.2019.109652","volume":"127","author":"HK Min","year":"2019","unstructured":"Min, H. K. et al. Bacteriology and resistance patterns of otitis media with effusion. Int. J. Pediatr. Otorhinolaryngol. 127, 109652 (2019).","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"91736_CR22","doi-asserted-by":"publisher","first-page":"3","DOI":"10.2165\/11538720-S0-000000000-00002","volume":"12","author":"R Dagan","year":"2010","unstructured":"Dagan, R. Appropriate treatment of acute otitis media in the ear of antibiotic resistance. Paediatr. Drugs. 12, 3\u20139 (2010).","journal-title":"Paediatr. Drugs."},{"key":"91736_CR23","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jpeds.2019.08.043","volume":"215","author":"SW Hum","year":"2019","unstructured":"Hum, S. W., Shaikh, K. J., Musa, S. S. & Shaikh, N. Adverse events of antibiotics used to treat acute otitis media. J. Pediatr. 215, 139\u2013143 (2019).","journal-title":"J. Pediatr."},{"key":"91736_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijporl.2019.109616","volume":"126","author":"SC Barrera","year":"2019","unstructured":"Barrera, S. C., Cancino, R. S. & Barreto, T. W. The impact of continuity of care on antibiotic prescribing in acute otitis media. Int. J. Pediatr. Otorhinolaryngol. 126, 1\u20134 (2019).","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"91736_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41746-019-0094-0","volume":"2","author":"GL Monroy","year":"2019","unstructured":"Monroy, G. L. et al. Automated classification platform for the identification of otitis media using optical coherence tomography. NPJ Digit. Med. 2, 1\u201311 (2019).","journal-title":"NPJ Digit. Med."},{"key":"91736_CR26","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1364\/BOE.8.000230","volume":"8","author":"DS Jung","year":"2017","unstructured":"Jung, D. S., Crowe, J. A., Birchall, J. P., Somekh, M. G. & See, C. W. Anti-confocal assessment of middle ear inflammation. Biomed. Opt. Express. 8, 230\u2013242 (2017).","journal-title":"Biomed. Opt. Express."},{"key":"91736_CR27","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1177\/1357633X17708531","volume":"24","author":"AC Moberly","year":"2018","unstructured":"Moberly, A. C., Zhang, M. & Yu, L. Digital otoscopy versus microscopy: How correct and confident are ear experts in their diagnoses?. J. Telemed. Telecare. 24, 453\u2013459 (2018).","journal-title":"J. Telemed. Telecare."},{"key":"91736_CR28","first-page":"2777","volume":"6","author":"CK Chen","year":"2016","unstructured":"Chen, C. K., Fang, J., Wan, Y. L. & Tsui, P. H. Ultrasound characterization of the mastoid for detecting middle ear effusion: A preliminary clinical validation. Sci. Rep. 6, 2777 (2016).","journal-title":"Sci. Rep."},{"key":"91736_CR29","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1177\/0194599818809337","volume":"160","author":"T Marom","year":"2019","unstructured":"Marom, T., Kraus, O., Habashi, N. & Tamir, S. O. Emerging technologies for the diagnosis of otitis media. Otolaryngol. Head Neck Surg. 160, 447\u2013456 (2019).","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"91736_CR30","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1002\/jbio.201500313","volume":"10","author":"GL Monroy","year":"2017","unstructured":"Monroy, G. L. et al. Non-invasive optical assessment of viscosity of middle ear effusions in otitis media. J. Biophoton. 10, 394\u2013403 (2017).","journal-title":"J. Biophoton."},{"key":"91736_CR31","doi-asserted-by":"publisher","first-page":"121614","DOI":"10.1117\/1.JBO.22.12.121614","volume":"22","author":"GL Monroy","year":"2017","unstructured":"Monroy, G. L. et al. Noninvasive in vivo optical coherence tomography tracking of chronic otitis media in pediatric subjects after surgical intervention. J. Biomed. Opt. 22, 121614 (2017).","journal-title":"J. Biomed. Opt."},{"key":"91736_CR32","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.ijporl.2018.08.024","volume":"114","author":"TA Valdez","year":"2018","unstructured":"Valdez, T. A. et al. Initial findings of shortwave infrared otoscopy in a pediatric population. Int. J. Pediatr. Otorhinolaryngol. 114, 15\u201319 (2018).","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"91736_CR33","doi-asserted-by":"publisher","first-page":"9989","DOI":"10.1073\/pnas.1610529113","volume":"113","author":"JA Carr","year":"2016","unstructured":"Carr, J. A., Valdez, T. A., Bruns, O. T. & Bawendi, M. G. Using the shortwave infrared to image middle ear pathologies. Proc. Natl. Acad. Sci. U.S.A. 113, 9989\u20139994 (2016).","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"91736_CR34","doi-asserted-by":"publisher","first-page":"3277","DOI":"10.1007\/s00216-015-8580-y","volume":"407","author":"TA Valdez","year":"2015","unstructured":"Valdez, T. A. et al. Multi-color reflectance imaging of middle ear pathology in vivo. Anal. Bioanal. Chem. 407, 3277\u20133283 (2015).","journal-title":"Anal. Bioanal. Chem."},{"key":"91736_CR35","doi-asserted-by":"publisher","first-page":"4379","DOI":"10.3390\/s20164379","volume":"20","author":"GM Atigur Rahaman","year":"2020","unstructured":"Atigur Rahaman, G. M., Parkkinen, J. & Hauta-Kasari, M. A novel approach to using spectral imaging to classify dyes in colored fibers. Sensors 20, 4379 (2020).","journal-title":"Sensors"},{"key":"91736_CR36","first-page":"607","volume":"12139","author":"DV Lucena","year":"2020","unstructured":"Lucena, D. V., Soares, A. S., Coelho, C. J. & Wastowski, I. J. Detection of tumoral epithelial lesions using hyperspectral imaging and deep learning. Int. Conf. Comput. Sci. 12139, 607\u2013609 (2020).","journal-title":"Int. Conf. Comput. Sci."},{"key":"91736_CR37","doi-asserted-by":"publisher","first-page":"2185","DOI":"10.1007\/s11548-016-1449-5","volume":"11","author":"D Nouri","year":"2016","unstructured":"Nouri, D., Lucas, Y. & Treuillet, S. Hyperspectral interventional imaging for enhanced tissue visualization and discrimination combining band selection methods. Int. J. Comput. Assist. Radiol. Surg. 11, 2185\u20132197 (2016).","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"91736_CR38","doi-asserted-by":"publisher","first-page":"4352","DOI":"10.1038\/s41467-018-06799-6","volume":"9","author":"J Wu","year":"2018","unstructured":"Wu, J. et al. Master clinical medical knowledge at certificated-doctor-level with deep learning model. Nat. Commun. 9, 4352 (2018).","journal-title":"Nat. Commun."},{"key":"91736_CR39","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1038\/s41592-018-0267-9","volume":"16","author":"R Strack","year":"2019","unstructured":"Strack, R. Deep learning in imaging. Nat. Methods. 16, 17 (2019).","journal-title":"Nat. Methods."},{"key":"91736_CR40","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1038\/s41592-018-0261-2","volume":"16","author":"T Falk","year":"2019","unstructured":"Falk, T. et al. U-Net: Deep learning for cell counting, detection, and morphometry. Nat. Methods. 16, 67\u201370 (2019).","journal-title":"Nat. Methods."},{"key":"91736_CR41","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1093\/bib\/bbx044","volume":"19","author":"R Miotto","year":"2018","unstructured":"Miotto, R., Wang, F., Wang, S., Jiang, X. & Dudley, J. T. Deep learning for healthcare: Review, opportunities and challenges. Brief. Bioinform. 19, 1236\u20131246 (2018).","journal-title":"Brief. Bioinform."},{"key":"91736_CR42","volume-title":"Classification in BioApps. Lecture Notes in Computational Vision and Biomechanics","author":"MI Razzak","year":"2018","unstructured":"Razzak, M. I., Naz, S. & Zaib, A. Deep Learning for Medical Image Processing: Overview, challenges and the future. In Classification in BioApps. Lecture Notes in Computational Vision and Biomechanics Vol. 26 (eds Dey, N. et al.) (Springer, Cham, 2018)."},{"key":"91736_CR43","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1002\/lary.27850","volume":"130","author":"MG Crowson","year":"2020","unstructured":"Crowson, M. G. et al. A contemporary review of machine learning in otolaryngology \u2013 head and neck surgery. Laryngoscope 130, 45\u201351 (2020).","journal-title":"Laryngoscope"},{"key":"91736_CR44","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1002\/lary.28292","volume":"130","author":"D Livingstone","year":"2020","unstructured":"Livingstone, D. & Chau, J. Otoscopic diagnosis using computer vision: An automated machine learning approach. Laryngoscope 130, 1408\u20131413 (2020).","journal-title":"Laryngoscope"},{"key":"91736_CR45","doi-asserted-by":"publisher","first-page":"e0229226","DOI":"10.1371\/journal.pone.0229226","volume":"15","author":"M Viscaino","year":"2020","unstructured":"Viscaino, M. et al. Computer aided diagnosis of external and middle ear conditions: a machine learning approach. PLoS ONE 15, e0229226 (2020).","journal-title":"PLoS ONE"},{"key":"91736_CR46","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1055\/s-2007-997586","volume":"75","author":"H Feldmann","year":"1996","unstructured":"Feldmann, H. History of the ear speculum. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt Laryngo. Rhino. Otol. 75, 311\u2013318 (1996).","journal-title":"Rhino. Otol."},{"key":"91736_CR47","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1097\/00005537-200010000-00031","volume":"110","author":"VJ Jaisinghani","year":"2000","unstructured":"Jaisinghani, V. J., Hunter, L. L., Li, Y. & Margolis, R. H. Quantitative analysis of tympanic membrane disease using video-otoscopy. Laryngoscope 110, 1726\u20131730 (2000).","journal-title":"Laryngoscope"},{"key":"91736_CR48","first-page":"6219845","volume":"2020","author":"TT Van","year":"2020","unstructured":"Van, T. T., Thao, M. L. T., Quynh, L. B. M., Khuong, C. P. N. & Quang, L. H. Application of multispectral imaging in the human tympanic membrane. J. Healthc. Eng. 2020, 6219845 (2020).","journal-title":"J. Healthc. Eng."},{"key":"91736_CR49","doi-asserted-by":"publisher","first-page":"10454","DOI":"10.1021\/ac5030232","volume":"86","author":"TA Valdez","year":"2014","unstructured":"Valdez, T. A. et al. Multiwavelength fluorescence otoscope for video-rate chemical imaging of middle ear pathology. Anal. Chem. 86, 10454\u201310460 (2014).","journal-title":"Anal. Chem."},{"key":"91736_CR50","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1364\/BOE.8.000230","volume":"8","author":"DS Jung","year":"2017","unstructured":"Jung, D. S., Crowe, J. A., Birchall, J. P., Somekh, M. G. & See, C. W. Anti-confocal assessment of middle ear inflammation. Biomed. Opt. Express. 8, 230\u2013242 (2017).","journal-title":"Biomed. Opt. Express."},{"key":"91736_CR51","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1177\/0194599818775711","volume":"09","author":"HEI Tan","year":"2018","unstructured":"Tan, H. E. I. et al. Optical coherence tomography of the tympanic membrane and middle ear: A review. Otolaryngol. Head. Neck. Surg. 09, 424\u2013438 (2018).","journal-title":"Otolaryngol. Head. Neck. Surg."},{"key":"91736_CR52","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s10162-016-0576-6","volume":"17","author":"P Pande","year":"2016","unstructured":"Pande, P., Shelton, R. L., Monroy, G. L., Nolan, R. M. & Boppart, S. A. A mosaicking approach for in vivo thickness mapping of the human tympanic membrane using low coherence interferometry. J. Assoc. Res. Otolaryngol. 17, 403\u2013416 (2016).","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"91736_CR53","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1364\/BOE.9.000397","volume":"9","author":"J Won","year":"2018","unstructured":"Won, J. et al. Pneumatic low-coherence interferometry otoscope to quantify tympanic membrane mobility and middle ear pressure. Biomed. Opt. Express. 9, 397\u2013409 (2018).","journal-title":"Biomed. Opt. Express."},{"key":"91736_CR54","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s10162-013-0394-z","volume":"14","author":"S Van der Jeught","year":"2013","unstructured":"Van der Jeught, S. et al. Full-field thickness distribution of human tympanic membrane obtained with optical coherence tomography. J. Assoc. Res. Otolaryngol. 14, 483\u2013494 (2013).","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"91736_CR55","doi-asserted-by":"publisher","first-page":"2","DOI":"10.4172\/2324-8785.1000312","volume":"6","author":"S Van der Jeught","year":"2017","unstructured":"Van der Jeught, S. & Dirckx, J. Recent developments in full-field thickness measurements of the human eardrum. J. Otol. Rhinol. 6, 2 (2017).","journal-title":"J. Otol. Rhinol."},{"key":"91736_CR56","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1097\/MAO.0b013e3181e711b8","volume":"31","author":"HR Djalilian","year":"2010","unstructured":"Djalilian, H. R. et al. Optical coherence tomography of cholesteatoma. Otol. Neurotol. 31, 932\u2013935 (2010).","journal-title":"Otol. Neurotol."},{"key":"91736_CR57","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1097\/MAO.0b013e31818a08ce","volume":"29","author":"HR Djalilian","year":"2008","unstructured":"Djalilian, H. R. et al. Imaging the human tympanic membrane using optical coherence tomography in vivo. Otol Neurotol. 29, 1091\u20131094 (2008).","journal-title":"Otol Neurotol."},{"key":"91736_CR58","doi-asserted-by":"publisher","first-page":"80910Y","DOI":"10.1117\/12.889734","volume":"8091","author":"A Burkhardt","year":"2011","unstructured":"Burkhardt, A. et al. Endoscopic optical coherence tomography for imaging the tympanic membrane. Proc. SPIE 8091, 80910Y (2011).","journal-title":"Proc. SPIE"},{"key":"91736_CR59","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/j.heares.2013.04.001","volume":"301","author":"CT Nguyen","year":"2013","unstructured":"Nguyen, C. T. et al. Investigation of bacterial biofilm in the human middle ear using optical coherence tomography and acoustic measurements. Hear. Res. 301, 193\u2013200 (2013).","journal-title":"Hear. Res."},{"key":"91736_CR60","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1515\/cdbme-2016-0098","volume":"2","author":"L Kirsten","year":"2016","unstructured":"Kirsten, L. et al. Doppler optical coherence tomography as a promising tool for detecting fluid in the human middle ear. Curr. Dir. Biomed. Eng. 2, 443\u2013447 (2016).","journal-title":"Curr. Dir. Biomed. Eng."},{"key":"91736_CR61","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1177\/0194599819900762","volume":"162","author":"D Preciado","year":"2020","unstructured":"Preciado, D. et al. Otitis media middle ear effusion identification and characterization using an optical coherence tomography otoscope. Otolaryngol. Head Neck Surg. 162, 367\u2013374 (2020).","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"91736_CR62","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.ebiom.2019.06.050","volume":"45","author":"D Cha","year":"2019","unstructured":"Cha, D. et al. Automated diagnosis of ear disease using ensemble deep learning with a big otoendoscopy image database. EBioMedicine 45, 606\u2013614 (2019).","journal-title":"EBioMedicine"},{"key":"91736_CR63","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1017\/S0022215120000717","volume":"134","author":"AR Habib","year":"2020","unstructured":"Habib, A. R., Wong, E., Sacks, R. & Singh, N. Artificial intelligence to detect tympanic membrane perforations. J. Laryngol. Otol. 134, 311\u2013315 (2020).","journal-title":"J. Laryngol. Otol."},{"key":"91736_CR64","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.neunet.2020.03.023","volume":"126","author":"MA Khan","year":"2020","unstructured":"Khan, M. A. et al. Automatic detection of tympanic membrane middle ear infection from oto-endoscopic images via convolutional neural networks. Neural. Netw. 126, 384\u2013394 (2020).","journal-title":"Neural. Netw."},{"key":"91736_CR65","doi-asserted-by":"publisher","first-page":"E1668","DOI":"10.1002\/lary.29253","volume":"131","author":"H Binol","year":"2021","unstructured":"Binol, H. et al. Digital otoscopy videos versus composite images: A reader study to compare the accuracy of ENT physicians. Laryngoscope 131, E1668\u2013E1676 (2021).","journal-title":"Laryngoscope"},{"key":"91736_CR66","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1001\/2013.jamaoto.337","volume":"138","author":"SK Sridhara","year":"2012","unstructured":"Sridhara, S. K. & Brietzke, S. E. The \u201cspoke sign\u201d: An otoscopic diagnostic aid for detecting otitis media with effusion. Arch. Otolaryngol. Head Neck Surg. 138, 1059\u20131063 (2012).","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"91736_CR67","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1016\/j.ijporl.2009.02.012","volume":"73","author":"DE Young","year":"2009","unstructured":"Young, D. E., Ten Cate, W. J., Ahmad, Z. & Morton, R. P. The accuracy of otomicroscopy for the diagnosis of paediatric middle ear effusions. Int. J. Pediatr. Otorhinolaryngol. 73, 825\u2013858 (2009).","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"91736_CR68","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1017\/S0022215114001352","volume":"128","author":"JC Wang","year":"2014","unstructured":"Wang, J. C. et al. Measurement of sound intensity during suction of middle-ear fluid following myringotomy. J. Laryngol. Otol. 128, 604\u2013611 (2014).","journal-title":"J. Laryngol. Otol."},{"key":"91736_CR69","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1046\/j.1365-2273.1999.00240.x","volume":"24","author":"AH Jardine","year":"1999","unstructured":"Jardine, A. H., Maw, A. R. & Coulton, S. Dry tap at myringotomy: A three-year study of 1688 children undergoing myringotomy. Clin. Otolaryngol. Allied Sci. 24, 266\u2013269 (1999).","journal-title":"Clin. Otolaryngol. Allied Sci."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-91736-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-91736-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-91736-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T13:14:27Z","timestamp":1675430067000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-91736-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,15]]},"references-count":69,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["91736"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-91736-9","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,15]]},"assertion":[{"value":"26 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"12509"}}