The CPET part of the CLE test was performed as described above. After application of local anaesthesia (Lidocaine), a flexible fibreoptic laryngoscope (Olympus ENF-V2, Tokyo, Japan) with diameter 3.4 mm was introduced into the pharyngeal space via a tight-fit opening in a slightly modified Hans Rudolph facemask and through one nostril (figure 1 ). The mask was tested for air leaks and the laryngoscope was secured with tape and positioned for a good view of the laryngeal entrance, including supraglottic structures and the vocal folds. The body of the laryngoscope was secured to the head of the test person by custom-made headgear. During the treadmill test, the added CLE equipment allowed for videorecording of the laryngeal inlet (figure 1 ).
Enf v2
Manufactured by Olympus
Sourced in Japan
The ENF-V2 is a flexible, video rhinolaryngoscope designed for upper airway examination. It features a slim, distal tip and high-resolution image sensor for clear visualization of the larynx and pharynx. The device is equipped with LED illumination and supports video recording capabilities.
Automatically generated - may contain errors
6 protocols using enf v2
1
Flexible Fibreoptic Laryngoscopy During CPET
2
Tympanic Membrane Image Database
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A database of tympanic membrane images of individuals who visited the otolaryngology department from January 2015 to December 2020 was available for training and validation of the machine learning network. Images of the tympanic membranes were acquired by a Digital Videoscope (ENF-V2, Olympus, Tokyo, Japan) and registered in a Picture Archiving and Communication System, and the images were extracted and saved in JPEG format, with a resolution of 640 × 480.
3
Removal of Ingested Fish Bones
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Examination and treatment were performed basically as follows. (1) When a fish bone was identified in the oral cavity or the mesopharynx, it was removed by “direct removal” using a tongue depressor and several types of forceps without the use of endoscopes. (2) In other cases, a flexible videoendoscopy(OTV-S190 and ENF-V2, Olympus, Tokyo, Japan) was performed to observe the mesopharynx and hypopharynx. When a fish bone was located, it was removed by “endoscopic removal” using a flexible videoendoscope with an instrument channel (OTV-S190 and ENF-VT2, Olympus, Tokyo, Japan) allowing passage of a grasping forceps under local anesthesia [15 (link), 16 (link)]. (3) When the flexible endoscopic examination failed to detect the foreign body and residue in the hypopharynx or the esophagus was still suspected, we performed a non-contrast computed tomography (CT) scan (GE BrightSpeed Elite 16, GE Healthcare, Chicago, Illinois, USA). (4) If a foreign body was detected by CT scan, it was removed via “endoscopic removal” by gastroenterologists. (5) In patients with a high risk of esophageal perforation or in cases of unsuccessful endoscopic removal, otolaryngologists performed the removal using a direct pharyngoesophagoscope under general anesthesia or via external cervical incision, and we refer to these removal techniques as “surgery”.
4
Multimodal Assessment of Airway Physiology
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A 12‐lead portable electrocardiograph device was attached to the subject. Nostrils and nasal cavity were anesthetized with 4% lidocaine. An endoscopic video camera system (Visera, CLV‐S40; Olympus, Tokyo, Japan) was connected to a fiberoptic laryngoscope (ENF‐V2; Olympus) in a sterile plastic cover with work channel, which was advanced through a hole in a modified facemask (Hans Rudolph, Inc., Kansas City, MO) through the nasal cavity to the oropharynx. Lidocaine (4%) was used to anesthetize the vocal folds and proximal trachea by a dripping technique through the work channel. The laryngoscope was fixed to the headset. Two pressure sensors (Mikro‐Cath 825‐0101; Milar, Houston, TX) were introduced through the work channel. The first was positioned approximately at the first tracheal ring. The second was positioned at the epiglottis tip. The sensors were secured to the headset and connected to a data‐acquisition box (Powerbox 8/35; ADInstruments, Oxford, United Kingdom), and data were collected and stored on a MacBook Pro laptop (Apple Inc., Cupertino, CA) using LabChart 8.0 software (ADInstruments). Data acquisition was set at 40 Hz. A video camera and microphone were placed in front of the subject to document external images and sounds, and the ergo‐spirometry unit was attached to the facemask.
5
Laryngoscopic Examination of Vocal Responses
6
Annotated Tympanic Membrane Image Dataset
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The medical records and tympanic membrane images of patients who visited the otolaryngology department for ear problems from January 2015 to December 2018 were retrospectively reviewed. Tympanic membrane images were obtained using a Digital Videoscope (ENF-V2, Olympus) and were stored in the Picture Archiving and Communication System. Images were extracted and saved in JPEG format with a resolution of 640 × 480. Each tympanic membrane image was annotated with the correct diagnosis of normal, otitis media with effusion (OME), chronic otitis media (COM), or cholesteatoma by three otolaryngology specialists based on endoscopic images and corresponding medical records including operation records or audiologic tests. OME was diagnosed by the presence of middle ear effusion with an intact tympanic membrane. COM refers to the conditions of a perforated tympanic membrane with or without otorrhea. Cholesteatoma was diagnosed based on the presence of a retraction pocket or bony destruction with cholesteatoma debris (Figure 1 ). Images with other diagnoses or poor quality were excluded from the present study.
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