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Design of a Low‐Cost, USB‐Compatible, Otoscope Image‐Capture System

INTRODUCTION Despite abundant applications in telemedicine, education, and medical-legal documentation, physicians may hesitate to purchase currently available video otoscope systems because of their relatively high cost, low portability, and lack of integration with devices already present in the clinic. To this end, we produced a prototype lens system that fits a standard Welch-Allyn otoscope and captures images of the tympanic membrane (TM) with a charge coupled device (CCD) array from an USB 2.0-compatible web camera (Fig. 1). Image data are fed to a laptop or personal computer in real time, thus maximizing portability and eliminating the need to purchase stand-alone processing units. Large-scale production of this device would result in a unit that costs approximately $250 USD in comparison with non-PC compatible stand-alone devices that cost from $1,000 to $35,000 USD or more. In consideration of its portability, low cost, and ability to integrate readily with personal computers already in most clinics, this device has important applications in telemedicine, health care education, and in the medical-legal arena for documentation purposes. The diagnosis of middle ear disease can pose a challenge to health care practitioners; large geographic distances between patients and specialists may compound these challenges.1 Currently, there are three general options for capturing images of the TM: a microscope with camera attachment, “oto-endoscopy” systems, and video otoscope systems. The former two options are costly ( $20,000 USD) and are generally only found in the offices of otolaryngologists and neurootologists. The latter option is less costly, but at a cost of $1000 to $2,500 USD, it may be impractical or costprohibitive for primary care physicians and the growing workforce of nonphysician health care providers. A further limitation of current video otoscope systems is that they often require purchase of dedicated endoscopes or image processors. No system to date completely integrates with the commonly available technology found in most clinics: personal computers and standard otoscopes. The development of low-cost CCD cameras for use with personal computers (web cameras) provided the impetus to develop a cost-effective method of capturing images of the TM and middle ear. We selected a commonly available consumer web camera (QuickCam for Notebooks Deluxe, Logitech, Fremont, CA) on the basis of cost (retail $59.99 USD) and the easy access it offers to a CCD array with a one mega-pixel image resolution. A focal plane array at or above 640 480 pixels has been previously validated for evaluation of TM pathology.2 In the United States, the Welch-Allyn 3.5v halogen otoscope (Skaneateles Falls, NY) is ubiquitous in primary care settings. Therefore, we designed our lens system to incorporate the speculum systems and illumination provided by this otoscope model. Images pass through a lens system and onto the web camera’s CCD From University of California Irvine School of Medicine (J.-P.P.), Irvine, California, U.S.A., the Department of Engineering (R.J.), Harvey Mudd College, Claremont, California, U.S.A., the Department of Otolaryngology–Head and Neck Surgery (R.L.C.), University of California Irvine, Irvine, California, U.S.A., and the Department of Otolaryngology–Head and Neck Surgery and the Department of Biomedical Engineering, University of California Irvine, and the Beckman Laser Institute (B.J.W.), Irvine, California, U.S.A. Editor’s Note: This Manuscript was accepted for publication August 22, 2006. Paper was presented at the Triological Society (Western Section Meeting), Indian Wells, California, U.S.A., February 2, 2003. This research was supported by an educational grant from the Irvine Head and Neck Research Foundation and in part by the National Institutes of Health. Send correspondence to Dr. Brian J.-F. Wong, 1002 Health Sciences Road, Irvine CA 92612. E-mail: bjwong@orion.oac.uci.edu