Smartphone Otoscopy Sans Attachment: A Paradigm Shift in Diagnosing Ear Pathologies

OBJECTIVE: To study the validity of smartphone otoscopy. SETTING: Ear, nose, and throat (ENT) outpatient clinic of a tertiary care hospital in eastern India. STUDY DESIGN: Experimental study design to compare the efficacy of smartphone otoscopy with otoendoscopes. SUBJECTS AND METHODS: One hundred tympanic membranes (TMs) of 50 patients were examined and photographed by third-year senior residents (6 years of ENT training) using a zero-degree otoendoscope. The same 100 ears were then examined using a smartphone. Assistive light of the phone was used to illuminate the ear canal. The camera of the phone was focused to visualize and photograph the TM. RESULTS: Compared with the gold-standard otoendoscopes, smartphones could correctly diagnose 75% of the cases. Sensitivity and specificity of smartphone otoscopy were 87.8% and 80%, respectively. Positive predictive value was 90.6%, whereas negative predictive value was 75%. Smartphone otoscopy could correctly diagnose 88.57% of normal TMs, 86.36% of retracted TMs, and 82.85% of perforated TMs. CONCLUSION: This modality of “smart otoscopy” has no added cost and can be used by most doctors after minimal training. It is an excellent teaching tool and can be used universally even in resource-limited settings.