Evaluation of video-otoscopes suitable for tele-otology

The objectives of this study were to assess the quality of digitized video-otoscopes as well as its ease of use and safety. Four video-otoscopes available in Australia were used to image 96 patients. At least 22 patients (age range 5-70 years) were imaged with each video-otoscope, and the images were stored in a JPEG format. Three experienced otolaryngologists assessed all images for quality, clarity, color accuracy, orientation of eardrum and therefore ability to make a definitive diagnosis. The grading was a five-level scale: poor, adequate, good, very good and excellent. Two telescope systems produced high quality images (>80% were adequate or better), essential for accurate diagnosis, but both were associated with increased risk for injury in unskilled hands. The MedRx video-otoscope produced high-quality images (87% were adequate or better), while the Welch Allyn Compact Video-otoscope produced poor image quality (only 40% were adequate or better). Both devices were seen to be safer to use than the telescope systems. The telescope systems and MedRx otoscope provided optimum quality images necessary for tele-otology. However, the telescope units were considered to be unsafe in unskilled hands. The MedRx can be recommended as a safe device producing high-quality images.