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\begin{document}

\title{Risk of self-injury by patients using video otoendoscopes aimed at home
market}



\author[1]{Waqas Jamil}%
\author[2]{Mark Simmons}%
\affil[1]{Heartlands Hospital}%
\affil[2]{University Hospitals Birmingham NHS Foundation Trust}%


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  \date{May 18, 2024}


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\begin{abstract}
Sir, We have recently become aware of new small (2.2mm to 5.5mm) ear wax
removal endoscopes (similar to otoendoscopes) aimed at the home market
(See Figure 1). These are powered by USB attachments and can be viewed
on mobile phones or home PCs. They are targeted at the home market for
examination of ears, nose, and mouths and even some sellers advocate
using their use on pets too. They often come with attachments to allow
ear cleaning of wax and removal of foreign bodies etc. These are
available on various online seller websites and can cost as little as
\selectlanguage{ngerman}£11. These have been available for purchase for a few years, but we were
not aware of them until we started having some patients attend our
emergency ENT clinic recently having damaged their ear canals with them
during use. In one case, a child presented with extensive
abrasions/laceration of the ear canal after her mother attempted to
clean wax from the child's ears. Similarly, looking at the customer
reviews on these online seller websites, other buyers have reported harm
using these devices i.e. bleeding from the ear, pushing ear wax further
in the ear canal and resulting in hearing loss 1,2. Having purchased one
of these items for home research, we found the otoendoscope unwieldy and
it was difficult to gain a good image. Also with mono-ocular vision,
there is no depth perception, consequently this may increase the risk of
self-injury for new/untrained users. Whilst such devices may well be
helpful in the current COVID crisis and could be used for telemedicine
to help with distant patient examination during lockdowns 3,4, we would
like to highlight the potential dangers of the use of these items by the
public.%
\end{abstract}\selectlanguage{ngerman}%



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