{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:06:04Z","timestamp":1785326764582,"version":"3.55.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":5,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Otitis Media with Effusion (OME) is a prevalent childhood condition, affecting up to 90% of children with 10% progressing to a chronic state. It is commonly treated by tympanostomy tube placement. Diagnosis relies on clinical history, otoscopy, audiometry, and tympanometry, but these methods have a high false-positive rate of 15\u201328%. This highlights the need for an objective, reliable, and non-invasive diagnostic tool to reduce unnecessary surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To evaluate the rate of false-positive OME diagnoses in our tertiary hospital, a retrospective database analysis was conducted. To assess the feasibility of advanced imaging, experimental studies were performed ex vivo on human body donors. Sodium chloride solution was intratympanically injected under endoscopic guidance. Hyperspectral imaging (HSI) datasets were acquired using a customized endoscopic system to quantify tissue water content.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      An analysis of hospital records identified a false positive rate of 29% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094,564) for OME diagnosis, comparing the number of paracenteses to paracenteses plus tympanostomy tubes. In the ex vivo analysis of HSI, visual evaluation of the Tissue Water Index (TWI) demonstrated sensitivity, specificity, and accuracy of 89%, 78%, and 83%, respectively. The mean TWI of all evaluated tympanic membranes was 50.2 (\u00b1\u20097.1) before injection (control) and increased to 62.8 (\u00b1\u200914.8) after injection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HSI presents a highly sensitive and user-friendly potential future diagnostic adjunct for diagnosing OME, which has shown its potential in an ex vivo approach. Now it needs in-vivo confirmation of the results as its implementation in clinical routine could contribute to avoiding unnecessary surgical interventions, minimizing patient burden and healthcare costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-026-02611-w","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T10:15:18Z","timestamp":1784888118000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis of tympanic effusions using hyperspectral imaging to prevent unnecessary paracentesis procedures"],"prefix":"10.1186","volume":"26","author":[{"given":"Maximilian","family":"G\u00e4nzle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"L\u00f6ffler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis Gholami","family":"Bajestani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Unger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Dietz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Melzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Pirlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"K\u00f6hler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"2611_CR1","doi-asserted-by":"publisher","DOI":"10.1055\/b-001-2148","volume-title":"Praxis der HNO-Heilkunde, Kopf- und Halschirurgie","author":"J Strutz","year":"2010","unstructured":"Strutz J, Mann W. In:. Praxis der HNO-Heilkunde, Kopf- und Halschirurgie. 2., Vollst\u00e4ndig \u00fcberarbeitete und erweiterte Auflage ed. Stuttgart New York: Georg Thieme; 2010. https:\/\/doi.org\/10.1055\/b-001-2148.","edition":"2"},{"issue":"2","key":"2611_CR2","doi-asserted-by":"publisher","first-page":"466","DOI":"10.12669\/pjms.322.9009","volume":"32","author":"K Anwar","year":"2016","unstructured":"Anwar K, Khan S, Rehman HU, Javaid M, Shahabi I. Otitis media with effusion: Accuracy of tympanometry in detecting fluid in the middle ears of children at myringotomies. Pak J Med Sci. 2016;32(2):466\u201370. https:\/\/doi.org\/10.12669\/pjms.322.9009.","journal-title":"Pak J Med Sci"},{"key":"2611_CR3","unstructured":"Tos M. Pathology of acute otitis media and chronic secretory otitis media. Clin Rev Allergy. 1984;2(4):285-302."},{"key":"2611_CR4","doi-asserted-by":"publisher","unstructured":"Fiellau-Nikolajsen M. Epidemiology of secretory otitis media. A descriptive cohort study. Ann Otol Rhinol Laryngol. 983;92(2 Pt 1):172-77. https:\/\/doi.org\/10.1177\/000348948309200215.","DOI":"10.1177\/000348948309200215"},{"key":"2611_CR5","doi-asserted-by":"publisher","unstructured":"Monroy GL, et al. Automated classification platform for the identification of otitis media using optical coherence tomography. npj Digit Med. 2019;2(1):22. https:\/\/doi.org\/10.1038\/s41746-019-0094-0.","DOI":"10.1038\/s41746-019-0094-0"},{"key":"2611_CR6","doi-asserted-by":"publisher","unstructured":"Schmilovitch Z, Alchanatis V, Shachar M, Holdstein Y. Spectrophotometric otoscope: a new tool in the diagnosis of otitis media. J Near Infrared Spectrosc. 2007;15(4);209\u201315. https:\/\/doi.org\/10.1255\/jnirs.739.","DOI":"10.1255\/jnirs.739"},{"key":"2611_CR7","doi-asserted-by":"publisher","unstructured":"Kashani RG, et al. Shortwave infrared otoscopy for diagnosis of middle ear effusions: a machine-learning-based approach. Sci Rep. 2021;11(1):12509. https:\/\/doi.org\/10.1038\/s41598-021-91736-9.","DOI":"10.1038\/s41598-021-91736-9"},{"key":"2611_CR8","doi-asserted-by":"publisher","unstructured":"Carr JA, Valdez TA, Bruns OT, Bawendi MG. Using the shortwave infrared to image middle ear pathologies. Proc Natl Acad Sci U S A. 2016;113(36):9989-94. https:\/\/doi.org\/10.1073\/pnas.1610529113.","DOI":"10.1073\/pnas.1610529113"},{"key":"2611_CR9","doi-asserted-by":"publisher","unstructured":"Prasad A, Hasan SMA, Gartia MR. Optical Identification of middle ear infection. molecules. 2020;25(9):2239. https:\/\/doi.org\/10.3390\/molecules25092239.","DOI":"10.3390\/molecules25092239"},{"key":"2611_CR10","doi-asserted-by":"publisher","unstructured":"Cavalcanti TC, Lew HM, Lee K, Lee S-Y, Park MK, Hwang JY. Intelligent smartphone-based multimode imaging otoscope for the mobile diagnosis of otitis media. Biomed Opt Express. 2021;12(12):7765-79. https:\/\/doi.org\/10.1364\/BOE.441590.","DOI":"10.1364\/BOE.441590"},{"key":"2611_CR11","doi-asserted-by":"publisher","unstructured":"Pandey R, et al. Discerning the differential molecular pathology of proliferative middle ear lesions using Raman spectroscopy. Sci Rep. 2015;5:13305. https:\/\/doi.org\/10.1038\/srep13305.","DOI":"10.1038\/srep13305"},{"key":"2611_CR12","doi-asserted-by":"publisher","unstructured":"Seth R, Discolo CM, Palczewska GM, Lewandowski JJ, Krakovitz PR. Ultrasound characterization of middle ear effusion. Am J Otolaryngol. 2013;34(1):44\u201350. https:\/\/doi.org\/10.1016\/j.amjoto.2012.08.005.","DOI":"10.1016\/j.amjoto.2012.08.005"},{"key":"2611_CR13","doi-asserted-by":"publisher","unstructured":"Chen C-K, Lai Y-H, Hsieh L-C, Tsui P-H. Quantitative transmastoid ultrasound for detecting middle ear effusion in pediatric patients. Comput Methods Programs Biomed. 2023;236:107557. https:\/\/doi.org\/10.1016\/j.cmpb.2023.107557.","DOI":"10.1016\/j.cmpb.2023.107557"},{"key":"2611_CR14","doi-asserted-by":"publisher","unstructured":"M\u00fcnker G, Tratzm\u00fcller A. [Is there a drug therapy for sero-mucotympanum?]. Laryngorhinootologie. 1989;68(12):647-52. https:\/\/doi.org\/10.1055\/s-2007-998422.","DOI":"10.1055\/s-2007-998422"},{"key":"2611_CR15","unstructured":"Lautermann J, et al. S2k-Leitlinie Seromukotympanum; AWMF-Register Nr. 017\/004. 2018."},{"key":"2611_CR16","doi-asserted-by":"publisher","unstructured":"Maw AR, Herod F. Otoscopic, impedance, and audiometric findings in glue ear treated by adenoidectomy and tonsillectomy. A prospective randomised study. Lancet. 1986;1(8495):1399\u2013402. https:\/\/doi.org\/10.1016\/s0140-6736(86)91552-7.","DOI":"10.1016\/s0140-6736(86)91552-7"},{"key":"2611_CR17","unstructured":"Lildholdt T. Secretory otitis media. The significance of negative middle ear pressure and the results of a controlled study of ventilation tubes. Dan Med Bull. 1983;30(6):408-15."},{"key":"2611_CR18","doi-asserted-by":"publisher","unstructured":"Goldstein NA, Mandel EM, Kurs-Lasky M, Rockette HE, Casselbrant ML. Water precautions and tympanostomy tubes: a randomized, controlled trial. Laryngoscope. 2005;115(2):324\u201330. https:\/\/doi.org\/10.1097\/01.mlg.0000154742.33067.fb.","DOI":"10.1097\/01.mlg.0000154742.33067.fb"},{"key":"2611_CR19","doi-asserted-by":"publisher","unstructured":"Boudewyns A, et al. Otitis media with effusion: an underestimated cause of hearing loss in infants. Otol Neurotol. 2011;32(5):799\u2013804. https:\/\/doi.org\/10.1097\/MAO.0b013e31821b0d07.","DOI":"10.1097\/MAO.0b013e31821b0d07"},{"key":"2611_CR20","doi-asserted-by":"publisher","unstructured":"Lous J, Burton MJ, Felding JU, Ovesen T, Rovers MM, Williamson I. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2005;001801(1):CD. https:\/\/doi.org\/10.1002\/14651858.CD001801.pub2.","DOI":"10.1002\/14651858.CD001801.pub2"},{"key":"2611_CR21","doi-asserted-by":"publisher","unstructured":"Rosenfeld RM, et al. Clinical practice guideline: tympanostomy tubes in children. Otolaryngol --Head Neck Surg. 2013;149. https:\/\/doi.org\/10.1177\/0194599813487302.","DOI":"10.1177\/0194599813487302"},{"key":"2611_CR22","doi-asserted-by":"publisher","unstructured":"Sano S, Kamide Y, Schachern PA, Paparella MM. Micropathologic changes of pars tensa in children with otitis media with effusion. Arch Otolaryngol Head Neck Surg. 1994 Aug;120(8):815-9. https:\/\/doi.org\/10.1001\/archotol.1994.01880320019005.","DOI":"10.1001\/archotol.1994.01880320019005"},{"key":"2611_CR23","doi-asserted-by":"publisher","unstructured":"Thoma\u00dfen MT, et al. In vivo evaluation of a hyperspectral imaging system for minimally invasive surgery (HSI-MIS). Surg Endosc. 2023;37(5):3691\u2013700. https:\/\/doi.org\/10.1007\/s00464-023-09874-2.","DOI":"10.1007\/s00464-023-09874-2"},{"key":"2611_CR24","doi-asserted-by":"publisher","unstructured":"Holmer A, Marotz J, Wahl P, Dau M, K\u00e4mmerer PW. Hyperspectral imaging in perfusion and wound diagnostics - methods and algorithms for the determination of tissue parameters. Biomed Tech (Berl). 2018;63(5):547-56. https:\/\/doi.org\/10.1515\/bmt-2017-0155.","DOI":"10.1515\/bmt-2017-0155"},{"key":"2611_CR25","doi-asserted-by":"publisher","unstructured":"Pichichero ME. Diagnostic accuracy of otitis media and tympanocentesis skills assessment among pediatricians. Eur J Clin Microbiol Infect Dis. 2033;22(9):519\u201324. https:\/\/doi.org\/10.1007\/s10096-003-0981-8.","DOI":"10.1007\/s10096-003-0981-8"},{"key":"2611_CR26","doi-asserted-by":"publisher","unstructured":"Pichichero ME, Poole MD. Assessing diagnostic accuracy and tympanocentesis skills in the management of otitis media. Arch Pediatr Adolesc Med. 2001;155(10):1137-42. https:\/\/doi.org\/10.1001\/archpedi.155.10.1137.","DOI":"10.1001\/archpedi.155.10.1137"},{"key":"2611_CR27","doi-asserted-by":"publisher","unstructured":"Palmu A, Puhakka H, Rahko T, Takala AK. Diagnostic value of tympanometry in infants in clinical practice. Int J Pediatr Otorhinolaryngol. Aug. 1999;49(3):207\u201313. https:\/\/doi.org\/10.1016\/s0165-5876(99)00207-4.","DOI":"10.1016\/s0165-5876(99)00207-4"},{"key":"2611_CR28","doi-asserted-by":"publisher","unstructured":"Watters GW, Jones JE, Freeland AP. The predictive value of tympanometry in the diagnosis of middle ear effusion. Clin Otolaryngol Allied Sci. 1997;22(4):343\u20135. https:\/\/doi.org\/10.1046\/j.1365-2273.1997.00023.x.","DOI":"10.1046\/j.1365-2273.1997.00023.x"},{"key":"2611_CR29","doi-asserted-by":"publisher","unstructured":"Moberly AC, et al. Digital otoscopy versus microscopy: How correct and confident are ear experts in their diagnoses? J Telemed Telecare. 2018;24:453\u20139. https:\/\/doi.org\/10.1177\/1357633X17708531.","DOI":"10.1177\/1357633X17708531"},{"key":"2611_CR30","doi-asserted-by":"publisher","unstructured":"Jaisinghani VJ, Hunter LL, Li Y, Margolis RH. Quantitative analysis of tympanic membrane disease using video-otoscopy. Laryngoscope. 2000;110(10 Pt 1):1726-1730. https:\/\/doi.org\/10.1097\/00005537-200010000-00031.","DOI":"10.1097\/00005537-200010000-00031"},{"key":"2611_CR31","doi-asserted-by":"publisher","unstructured":"Preciado D, et al. Otitis media middle ear effusion identification and characterization using an optical coherence tomography otoscope. Otolaryngol Head Neck Surg. 2020;162(3):367-74. https:\/\/doi.org\/10.1177\/0194599819900762.","DOI":"10.1177\/0194599819900762"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-026-02611-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02611-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02611-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:30:13Z","timestamp":1785324613000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12880-026-02611-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2611"],"URL":"https:\/\/doi.org\/10.1186\/s12880-026-02611-w","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"assertion":[{"value":"25 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All body donors had given their informed consent to donate their bodies for research and teaching purposes before their passing. The experimental protocols were approved by the Ethics Committee of the Medical Faculty of the University of Leipzig (129\/21-ck). This study was conducted according to the Declaration of Helsinki.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"371"}}