Audiology Forum: Video Otoscopy by Roy F. Sullivan, Ph.D., R. F. Sullivan & C.A. Sullivan, Inc.,
Date of review: May 8, 1997.
Reviewed by Ron Kuppersmith, M.D.
Baylor College of Medicine
Bobby R. Alford Department of Otorhinolaryngology and
Communicative Sciences Houston, Texas 77030
Audiology Forum: Video Otoscopy is a website maintained by Roy Sullivan, Ph.D. This site is comprehensive, describing the specifications and application of video otoscopy in audiologic practice. The site also contains a large number of still images from clinical cases and several short video clips. The images are a powerful educational aid, demonstrating normal and pathologic states of the ear.
The content portion of the site is organized into several sections: "References on Video Otoscopy and Related Topics," "Selected Video Otoscopy Topics," Video Otoscopy Image/Case Section," and "Video Otoscopy Systems."
"References on Video Otoscopy and Related Topics" contains a short bibliography of video otoscopy articles in the literature. Four articles are available as Hypertext Markup Language (HTML) files from the bibliography. There are also links to related sites on this page.
The "Selected Video Otoscopy Topics" section has information about video otoscopy systems and its clinical applications. The section titled "Video Otoscopy System Client Side Image Map" contains a nice schematic of a video otoscopy system. The user can click on different components in the schematic, which, in turn, provides a description and pictures where applicable. This section also has a tutorial and quiz on auricular anatomy. The quiz demonstrates the potential of interactive multimedia use for medical education.
The next section contains video otoscopy images and cases and is divided into several sections: pinna/concha, external auditory canal, tympanic membrane /middle ear, and hearing aid morphology.
Each section is subdivided further and contains several images. For example, the external auditory canal section is further divided into sections on cerumen, exostoses, otitis externa, desquamation, foreign bodies, postcerumenectomy status, conditions requiring hearing aid morphology modifications, neoplasms, temperomandibular joint, and others. Each subsection has between 2 and 12 pictures (JPEG format). Pictures that require further explanation often are accompanied by a text description.
The pictures on the site typically vary between 10 and 30 kilobytes, meaning they can be downloaded in a reasonable amount of time over a 28.8 modem. The quality of the photographs varies, but almost all are clear. On many pictures, the anatomy and pathology are labeled which is extremely helpful for students. Inclusion of unlabeled versions of the pictures would be valuable also.
Finally, the "Video Otoscopy Systems" section contains several pictures of the equipment.
Audiology Forum: Video Otoscopy contains an almost overwhelming amount of useful information and attempts to be user-friendly by providing a lot of useful viewing suggestions in its Viewing Information FAQ (frequently asked questions). Unfortunately, the organization of the site is confusing and often redundant. The same topics are listed more than once on the main page, and hierarchy of the table of contents is not intuitive.
The most frustrating part of navigating this site is the extremely long main page. On a 1280 x 1024 display (which is even higher resolution than recommended for the site), it took 25 full screen scrolls to get from the top of the main page to the bottom. It took five full screen scrolls (including two of advertisements) just to get to the table of contents. Reorganizing the site into shorter pages would serve the user well.
Overall, this is an excellent site and is worth visiting. Audiology Forum: Video Otoscopy is an extremely useful reference for medical student and audiology student education and for anyone interested in purchasing a video otoscopy system. Audiology Forum: Video Otoscopy also is well maintained and frequently updated and displays the potential power and usefulness of the Internet in education that many other sites only promise.
Audiology Forum: Video Otoscopy
Date of review: January 1997.
Reviewed by Michael Lin Gray
Baylor College of Medicine
Houston, Texas 77030
Special System Recommendations: 1) High bandwidth connection to Internet due to heavy graphic content of site. 2) Video display capable of 24 bits (16.7 million colors) or 16 bits (64,000 colors) at 1024 x 768 resolution. 3) Video decoders capable of displaying [.JPG] and [.AVI] file formats.
This website is an online reference for audiologists and otologists who utilize video otoscopy in their practice. Dr. Sullivan has compiled a large number of interesting otologic case studies illustrated with corresponding video otoscopy images. The cases were collected from professionals including audiologists, otologists, dermatologists, and primary care physicians. The vast array of online images display a wide variety of otologic pathologies including traumatic injuries, birth anomalies, diseased ears, and surgically altered ears. The video otoscopy images are the central emphasis of this site and make it a valuable learning resource for both beginning and experienced professionals. The online images allow professionals to become more experienced at recognizing various pathologies that might be encountered in a daily practice.
The hypertext table of contents is indexed, easy to use, and allows for rapid access to the image library. The images are organized according to anatomical site and subject. Below is an example of a small portion of the site's organization:
13.0 Pinna/Concha: Graphic Tutorial
13.1 Acquired Anomalies
13.2 Congenital Anomalies
13.3 Conditions Requiring Hearing Aid Morphology Modification
13.4 Eczematous Conditions
13.6 Surgical Artifacts
13.7 TMJ/Auriculo-Facial Muscle Effects
13.8 Venous Lake
Another unique visual offering of this site is the inclusion of online motion video otoscopy, namely video real-time movies of interesting cases. One such movie displays the motion of the tympanic membrane as the air pressure changes during tympanometry.
In addition to the video otoscopy images, case presentations, and movies, Dr. Sullivan provides other references and information resources. An overview of the subject of video otoscopy is included, which reviews types of systems, applications, and techniques. A graphic tutorial of the article and associated nomenclature is included, as is an automated online quiz. Also provided is a list of text and online references pertaining to video otoscopy, the external ear, and related topics.
The site is well-organized and acts as both a continuing education resource and reference for professionals. Dr. Sullivan has applied some of the newer hypertext markup language (HTML) standards including inline objects and online forms for the automated quiz. The author states that the case examples and images used are not fully comprehensive and have been chosen because of their relevant subject matter regarding the audiological assessment of hearing, the selection, fitting and follow-up care of hearing aids, and potential indications for medical referral. Although a traditional resource such as Hawke's Diseases of the Ear: A Pocket Atlas may be more appropriate as a daily clinical reference, this website demonstrates that with the proper development and newer technologies, the Internet may become a powerful vehicle for disseminating information quickly and easily to a large audience.