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The future of otology

  • R K Jackler (a1) and T A Jan (a1)

Abstract

Background

The field of otology is increasingly at the forefront of innovation in science and medicine. The inner ear, one of the most challenging systems to study, has been rendered much more open to inquiry by recent developments in research methodology. Promising advances of potential clinical impact have occurred in recent years in biological fields such as auditory genetics, ototoxic chemoprevention and organ of Corti regeneration. The interface of the ear with digital technology to remediate hearing loss, or as a consumer device within an intelligent ecosystem of connected devices, is receiving enormous creative energy. Automation and artificial intelligence can enhance otological medical and surgical practice. Otology is poised to enter a new renaissance period, in which many previously untreatable ear diseases will yield to newly introduced therapies.

Objective

This paper speculates on the direction otology will take in the coming decades.

Conclusion

Making predictions about the future of otology is a risky endeavour. If the predictions are found wanting, it will likely be because of unforeseen revolutionary methods.

Copyright

Corresponding author

Author for correspondence: Prof Robert K Jackler, Department of Otolaryngology – Head and Neck Surgery, Stanford Ear Institute, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA E-mail: jackler@stanford.edu Fax: +1 650 725 8502

Footnotes

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Prof R K Jackler takes responsibility for the integrity of the content of the paper

R K Jackler was The Journal of Laryngology & Otology 2019 Visiting Professor.

Footnotes

References

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1Sioshansi, PC, Jackler, RK, Alyono, JC. Practice of otology during the first quarter century of the American Otological Society (1868–1893). Otol Neurotol 2018;39:S10–29
2Aronson, SH. The sociology of the telephone. Int J Comp Sociol 1971;12:153–67
3Mudry, A, Mills, M. The early history of the cochlear implant: a retrospective. JAMA Otolaryngol Head Neck Surg 2013;139:446–53
4Hughes, GB. The decline of ear surgery in the 21st century. Am J Otol 2000;21:12
5Jackler, RK. Please don't close the patent office yet. Am J Otol 2000;21:34
6McKenna, MJ. The future of otology. Am J Otol 2000;21:456
7Rodriguez-Ruiz, A, Lång, K, Gubern-Merida, A, Broeders, M, Gennaro, G, Clauser, P et al. Stand-alone artificial intelligence for breast cancer detection in mammography: comparison with 101 radiologists. J Natl Cancer Inst 2019. Epub 2019 Mar 5
8Esteva, A, Kuprel, B, Novoa, RA, Ko, J, Swetter, SM, Blau, HM et al. Dermatologist-level classification of skin cancer with deep neural networks. Nature 2017;542:115–18
9Hashimoto, DA, Rosman, G, Rus, D, Meireles, OR. Artificial intelligence in surgery: promises and perils. Ann Surg 2018;268:70–6
10Verghese, A, Shah, NH, Harrington, RA. What this computer needs is a physician: humanism and artificial intelligence. JAMA 2018;319:1920
11Petersen, S, Houston, S, Qin, H, Tague, C, Studley, J. The utilization of robotic pets in dementia care. J Alzheimers Dis 2017;55:569–74
12Ross, A. The Industries of the Future. New York: Simon & Schuster, 2017;304
13Ford, M. Rise of the Robots: Technology and the Threat of a Jobless Future. New York: Basic Books, 2016;334
14Fitzgerald, MB, Jackler, RK. Assessment of hearing during the early years of the American Otological Society. Otol Neurotol 2018;39:S3042
15Canadian Agency for Drugs and Technologies in Health. Audiograms and Functional Auditory Testing to Assess Hearing Speech in Noise: A Review of the Clinical Evidence. Ottawa: Canadian Agency for Drugs and Technologies in Health, 2015
16Vendrametto, T, McAfee, JS, Hirsch, BE, Riviere, CN, Ferrigno, G, De Momi, E. Robot assisted stapedotomy ex vivo with an active handheld instrument. Conf Proc IEEE Eng Med Biol Soc 2015;2015:4879–82
17Montes Grande, G, Knisely, AJ, Becker, BC, Yang, S, Hirsch, BE, Riviere, CN. Handheld micromanipulator for robot-assisted stapes footplate surgery. Conf Proc IEEE Eng Med Biol Soc 2012;2012:1422–5
18Yasin, R, O'Connell, BP, Yu, H, Hunter, JB, Wanna, GB, Rivas, A et al. Steerable robot-assisted micromanipulation in the middle ear: preliminary feasibility evaluation. Otol Neurotol 2017;38:290–5
19Jackler, RK. A regenerative method of tympanic membrane repair could be the greatest advance in otology since the cochlear implant. Otol Neurotol 2012;33:289
20Holmes, D. Eardrum regeneration: membrane repair. Nature 2017;546:S5
21Santa Maria, PL, Weierich, K, Kim, S, Yang, YP. Heparin binding epidermal growth factor-like growth factor heals chronic tympanic membrane perforations with advantage over fibroblast growth factor 2 and epidermal growth factor in an animal model. Otol Neurotol 2015;36:1279–83
22Cox, MD, Trinidade, A, Russell, JS, Dornhoffer, JL. Long-term hearing results after ossiculoplasty. Otol Neurotol 2017;38:510–15
23Kozin, ED, Kiringoda, R, Lee, DJ. Incorporating endoscopic ear surgery into your clinical practice. Otolaryngol Clin North Am 2016;49:1237–51
24Tarabichi, M. Endoscopic management of acquired cholesteatoma. Am J Otol 1997;18:544–9
25Poe, D, Anand, V, Dean, M, Roberts, WH, Stolovitzky, JP, Hoffmann, K et al. Balloon dilation of the eustachian tube for dilatory dysfunction: a randomized controlled trial. Laryngoscope 2018;128:1200–6
26Mak, I, Hayes, AR, Khoo, B, Grossman, A. Peptide receptor radionuclide therapy as a novel treatment for metastatic and invasive phaeochromocytoma and paraganglioma. Neuroendocrinology 2019. Epub 2019 Mar 12
27Synodos for NF2 Consortium, Allaway, R, Angus, SP, Beauchamp, RL, Blakeley, JO, Bott, M et al. Traditional and systems biology based drug discovery for the rare tumor syndrome neurofibromatosis type 2. PloS One 2018;13:e0197350
28Xu, Y, Xia, N, Lim, M, Tan, X, Tran, MH, Boulger, E et al. Multichannel optrodes for photonic stimulation. Neurophotonics 2018;5:045002
29Gantz, BJ, Dunn, CC, Oleson, J, Hansen, MR. Acoustic plus electric speech processing: long-term results. Laryngoscope 2018;128:473–81
30Kiringoda, R, Kozin, ED, Lee, DJ. Outcomes in endoscopic ear surgery. Otolaryngol Clin North Am 2016;49:1271–90
31Hunter, JB, Rivas, A. Outcomes following endoscopic stapes surgery. Otolaryngol Clin North Am 2016;49:1215–25
32Garneau, JC, Laitman, BM, Cosetti, MK, Hadjipanayis, C, Wanna, G. The use of the exoscope in lateral skull base surgery: advantages and limitations. Otol Neurotol 2019;40:236–40
33Barber, SR, Wong, K, Kanumuri, V, Kiringoda, R, Kempfle, J, Remenschneider, AK et al. Augmented reality, surgical navigation, and 3D printing for transcanal endoscopic approach to the petrous apex. OTO Open 2018;2:2473974X18804492
34McJunkin, JL, Jiramongkolchai, P, Chung, W, Southworth, M, Durakovic, N, Buchman, CA et al. Development of a mixed reality platform for lateral skull base anatomy. Otol Neurotol 2018;39:e113742
35Marroquin, R, Lalande, A, Hussain, R, Guigou, C, Grayeli, AB. Augmented reality of the middle ear combining otoendoscopy and temporal bone computed tomography. Otol Neurotol 2018;39:931–9
36Alyono, JC, Corrales, CE, Huth, ME, Blevins, NH, Ricci, AJ. Development and characterization of chemical cochleostomy in the Guinea pig. Otolaryngol Head Neck Surg 2015;152:1113–18
37Iyer, JS, Batts, SA, Chu, KK, Sahin, MI, Leung, HM, Tearney, GJ et al. Micro-optical coherence tomography of the mammalian cochlea. Sci Rep 2016;6:33288
38Monfared, A, Blevins, NH, Cheung, ELM, Jung, JC, Popelka, G, Schnitzer, MJ. In vivo imaging of mammalian cochlear blood flow using fluorescence microendoscopy. Otol Neurotol 2006;27:144–52
39Hasin, Y, Seldin, M, Lusis, A. Multi-omics approaches to disease. Genome Biol 2017;18:83
40Regev, A, Teichmann, SA, Lander, ES, Amit, I, Benoist, C, Birney, E et al. The human cell atlas. eLife 2017;6:e27041
41Cao, J, Spielmann, M, Qiu, X, Huang, X, Ibrahim, DM, Hill, AJ et al. The single-cell transcriptional landscape of mammalian organogenesis. Nature 2019;566:496502
42Wang, J, Puel, J-L. Toward cochlear therapies. Physiol Rev 2018;98:2477–522
43Mehta, D, Noon, SE, Schwartz, E, Wilkens, A, Bedoukian, EC, Scarano, I et al. Outcomes of evaluation and testing of 660 individuals with hearing loss in a pediatric genetics of hearing loss clinic. Am J Med Genet A 2016;170:2523–30
44Hereditary Hearing Loss Homepage. In: https://hereditaryhearingloss.org [7 July 2019]
45Shendure, J, Balasubramanian, S, Church, GM, Gilbert, W, Rogers, J, Schloss, JA et al. DNA sequencing at 40: past, present and future. Nature 2017;550:345–53
46Shendure, J, Ji, H. Next-generation DNA sequencing. Nat Biotechnol 2008;26:1135–45
47Ranum, PT, Goodwin, AT, Yoshimura, H, Kolbe, DL, Walls, WD, Koh, J-Y et al. Insights into the biology of hearing and deafness revealed by single-cell RNA sequencing. Cell Rep 2019;26:3160–71.e3
48Ahmed, H, Shubina-Oleinik, O, Holt, JR. Emerging gene therapies for genetic hearing loss. J Assoc Res Otolaryngol 2017;18:649–70
49ClinicalTrials.gov. Safety, Tolerability and Efficacy for CGF166 in Patients with Unilateral or Bilateral Severe-to-profound Hearing Loss (Identifier NCT02132130). In: https://clinicaltrials.gov/ct2/show/NCT02132130 [7 July 2019]
50Cong, L, Ran, FA, Cox, D, Lin, S, Barretto, R, Habib, N et al. Multiplex genome engineering using CRISPR/Cas systems. Science 2013;339:819–23
51Hsu, PD, Lander, ES, Zhang, F. Development and applications of CRISPR-Cas9 for genome engineering. Cell 2014;157:1262–78
52Gao, X, Tao, Y, Lamas, V, Huang, M, Yeh, W-H, Pan, B et al. Treatment of autosomal dominant hearing loss by in vivo delivery of genome editing agents. Nature 2018;553:217–21
53Ren, Y, Sagers, JE, Landegger, LD, Bhatia, SN, Stankovic, KM. Tumor-penetrating delivery of siRNA against TNFα to human vestibular schwannomas. Sci Rep 2017;7:12922
54Isgrig, K, McDougald, DS, Zhu, J, Wang, HJ, Bennett, J, Chien, WW. AAV2.7m8 is a powerful viral vector for inner ear gene therapy. Nat Commun 2019;10:427
55Landegger, LD, Pan, B, Askew, C, Wassmer, SJ, Gluck, SD, Galvin, A et al. A synthetic AAV vector enables safe and efficient gene transfer to the mammalian inner ear. Nat Biotechnol 2017;35:280–4
56Tandon, V, Kang, WS, Robbins, TA, Spencer, AJ, Kim, ES, McKenna, MJ et al. Microfabricated reciprocating micropump for intracochlear drug delivery with integrated drug/fluid storage and electronically controlled dosing. Lab Chip 2016;16:829–46
57Mura, S, Nicolas, J, Couvreur, P. Stimuli-responsive nanocarriers for drug delivery. Nat Mater 2013;12:9911003
58Nyberg, S, Abbott, NJ, Shi, X, Steyger, PS, Dabdoub, A. Delivery of therapeutics to the inner ear: the challenge of the blood-labyrinth barrier. Sci Transl Med 2019;11:eaao0935
59Clemens, E, van den Heuvel-Eibrink, MM, Mulder, RL, Kremer, LCM, Hudson, MM, Skinner, R et al. Recommendations for ototoxicity surveillance for childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCare Consortium. Lancet Oncol 2019;20:e2941
60Brock, PR, Maibach, R, Childs, M, Rajput, K, Roebuck, D, Sullivan, MJ et al. Sodium thiosulfate for protection from cisplatin-induced hearing loss. N Engl J Med 2018;378:2376–85
61Muldoon, LL, Wu, YJ, Pagel, MA, Neuwelt, EA. N-acetylcysteine chemoprotection without decreased cisplatin antitumor efficacy in pediatric tumor models. J Neurooncol 2015;121:433–40
62World Health Organization. Critically Important Antimicrobials for Human Medicine. Geneva: WHO Document Production Services, 2011
63Van Boeckel, TP, Gandra, S, Ashok, A, Caudron, Q, Grenfell, BT, Levin, SA et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis 2014;14:742–50
64O'Sullivan, ME, Perez, A, Lin, R, Sajjadi, A, Ricci, AJ, Cheng, AG. Towards the prevention of aminoglycoside-related hearing loss. Front Cell Neurosci 2017;11:325
65Huth, ME, Han, K-H, Sotoudeh, K, Hsieh, Y-J, Effertz, T, Vu, AA et al. Designer aminoglycosides prevent cochlear hair cell loss and hearing loss. J Clin Invest 2015;125:583–92
66Song, J-J, Lee, BD, Lee, KH, Lee, JD, Park, YJ, Park, MK. Changes in antibiotic resistance in recurrent Pseudomonas aeruginosa infections of chronic suppurative otitis media. Ear Nose Throat J 2016;95:446–51
67Kealey, C, Creaven, CA, Murphy, CD, Brady, CB. New approaches to antibiotic discovery. Biotechnol Lett 2017;39:805–17
68Todd, DW, Philip, RC, Niihori, M, Ringle, RA, Coyle, KR, Zehri, SF et al. A fully automated high-throughput zebrafish behavioral ototoxicity assay. Zebrafish 2017;14:331–42
69Navalkele, BD, Revankar, S, Chandrasekar, P. Candida auris: a worrisome, globally emerging pathogen. Expert Rev Anti Infect Ther 2017;15:819–27
70Choi, HI, An, J, Hwang, JJ, Moon, S-Y, Son, JS. Otomastoiditis caused by Candida auris: case report and literature review. Mycoses 2017;60:488–92
71Tzounopoulos, T, Balaban, C, Zitelli, L, Palmer, C. Towards a mechanistic-driven precision medicine approach for tinnitus. J Assoc Res Otolaryngol 2019;20:115–32
72Ryan, D, Bauer, CA. Neuroscience of tinnitus. Neuroimaging Clin N Am 2016;26:187–96
73De Ridder, D, Vanneste, S, van der Loo, E, Plazier, M, Menovsky, T, van de Heyning, P. Burst stimulation of the auditory cortex: a new form of neurostimulation for noise-like tinnitus suppression. J Neurosurg 2010;112:1289–94
74Roberts, LE, Eggermont, JJ, Caspary, DM, Shore, SE, Melcher, JR, Kaltenbach, JA. Ringing ears: the neuroscience of tinnitus. J Neurosci 2010;30:14972–9
75Adamchic, I, Toth, T, Hauptmann, C, Walger, M, Langguth, B, Klingmann, I et al. Acute effects and after-effects of acoustic coordinated reset neuromodulation in patients with chronic subjective tinnitus. Neuroimage Clin 2017;15:541–58
76Shi, Y, Burchiel, KJ, Anderson, VC, Martin, WH. Deep brain stimulation effects in patients with tinnitus. Otolaryngol Head Neck Surg 2009;141:285–7
77Corwin, JT, Cotanche, DA. Regeneration of sensory hair cells after acoustic trauma. Science 1988;240:1772–4
78Atkinson, PJ, Huarcaya Najarro, E, Sayyid, ZN, Cheng, AG. Sensory hair cell development and regeneration: similarities and differences. Development 2015;142:1561–71
79Janesick, AS, Heller, S. Stem cells and the bird cochlea--where is everybody? Cold Spring Harb Perspect Med 2019;9:a033183
80Oshima, K, Grimm, CM, Corrales, CE, Senn, P, Martinez Monedero, R, Géléoc, GSG et al. Differential distribution of stem cells in the auditory and vestibular organs of the inner ear. J Assoc Res Otolaryngol 2007;8:1831
81Roccio, M, Perny, M, Ealy, M, Widmer, HR, Heller, S, Senn, P. Molecular characterization and prospective isolation of human fetal cochlear hair cell progenitors. Nat Commun 2018;9:4027
82Atkinson, PJ, Kim, GS, Cheng, AG. Direct cellular reprogramming and inner ear regeneration. Expert Opin Biol Ther 2018. Epub 2018 Dec 25
83Kujawa, SG, Liberman, MC. Adding insult to injury: cochlear nerve degeneration after ‘temporary’ noise-induced hearing loss. J Neurosci 2009;29:14077–85
84Liberman, MC, Kujawa, SG. Cochlear synaptopathy in acquired sensorineural hearing loss: manifestations and mechanisms. Hear Res 2017;349:138–47
85Simoni, E, Orsini, G, Chicca, M, Bettini, S, Franceschini, V, Martini, A et al. Regenerative medicine in hearing recovery. Cytotherapy 2017;19:909–15
86Zhang, T, Mustiere, F, Micheyl, C. Intelligent hearing aids: the next revolution. In: 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). Orlando: IEEE. 2016;72–6
87Reed, NS, Betz, J, Kendig, N, Korczak, M, Lin, FR. Personal sound amplification products vs a conventional hearing aid for speech understanding in noise. JAMA 2017;318:8990
88Lin, FR, Yaffe, K, Xia, J, Xue, Q-L, Harris, TB, Purchase-Helzner, E et al. Hearing loss and cognitive decline in older adults. JAMA Intern Med 2013;173:293–9
89Loughrey, DG, Kelly, ME, Kelley, GA, Brennan, S, Lawlor, BA. Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg 2018;144:115–26
90Sperling, NM, Yerdon, SE, D'Aprile, M. Extended-wear hearing technology: the nonimplantables. Otolaryngol Clin North Am 2019;52:221–30
91Chang, CYJ. Ossicle coupling active implantable auditory devices: magnetic driven system. Otolaryngol Clin North Am 2019;52:273–83
92Ghossaini, SN, Roehm, PC. Osseointegrated auditory devices: bone-anchored hearing aid and PONTO. Otolaryngol Clin North Am 2019;52:243–51
93den Besten, CA, Monksfield, P, Bosman, A, Skarzynski, PH, Green, K, Runge, C et al. Audiological and clinical outcomes of a transcutaneous bone conduction hearing implant: six-month results from a multicentre study. Clin Otolaryngol 2019;44:144–57
95Li, X, Dunn, J, Salins, D, Zhou, G, Zhou, W, Schüssler-Fiorenza Rose, SM et al. Digital health: tracking physiomes and activity using wearable biosensors reveals useful health-related information. PLoS Biol 2017;15:e2001402
96Maxmen, A. Google spin-off deploys wearable electronics for huge health study. Nature 2017;547:1314
97Jackler, RK. The impending end to the stigma of wearing ear devices and its revolutionary implications. Otol Neurotol 2006;27:299300
98Perez Fornos, A, Guinand, N, van de Berg, R, Stokroos, R, Micera, S, Kingma, H et al. Artificial balance: restoration of the vestibulo-ocular reflex in humans with a prototype vestibular neuroprosthesis. Front Neurol 2014;5:66
99Perez Fornos, A, Cavuscens, S, Ranieri, M, van de Berg, R, Stokroos, R, Kingma, H et al. The vestibular implant: a probe in orbit around the human balance system. J Vestib Res 2017;27:5161
100Phillips, JO, Ling, L, Nie, K, Jameyson, E, Phillips, CM, Nowack, AL et al. Vestibular implantation and longitudinal electrical stimulation of the semicircular canal afferents in human subjects. J Neurophysiol 2015;113:3866–92
101Lewis, RF. Vestibular implants studied in animal models: clinical and scientific implications. J Neurophysiol 2016;116:2777–88
102Chow, M, Gimmon, Y, Schoo, D, Trevino, C, Boutros, P, Rahman, M et al. First-in-human clinical trial of the MVI™ multichannel vestibular implant: continuous restoration of the human vestibulo-ocular reflex. In: Proceedings of the Association for Research in Otolaryngology 41st Annual MidWinter Meeting. San Diego: Association for Research in Otolaryngology, 2018
103Della Santina, CC. Perspective of a clinician-scientist: the labyrinth devices MVI™ vestibular implant – a case study on navigating the path from basic science to first-in-human trial. In: Proceedings of the Association for Research in Otolaryngology 41st Annual MidWinter Meeting. San Diego: Association for Research in Otolaryngology, 2018
104Schoo, D, Bowditch, S, Marsiglia, D, Boutros, P, Chow, M, Gimmon, Y et al. Long-term audiometric results from the first 3 subjects of the MVI™ multichannel vestibular implant early feasibility study. In: Proceedings of the Association for Research in Otolaryngology 41st Annual MidWinter Meeting. San Diego: Association for Research in Otolaryngology, 2018
105Ward, BK, Otero-Millan, J, Jareonsettasin, P, Schubert, MC, Roberts, DC, Zee, DS. Magnetic vestibular stimulation (MVS) as a technique for understanding the normal and diseased labyrinth. Front Neurol 2017;8:122
106Agrawal, Y, Carey, JP, Della Santina, CC, Schubert, MC, Minor, LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med 2009;169:938–44
107Agrawal, Y, Ward, BK, Minor, LB. Vestibular dysfunction: prevalence, impact and need for targeted treatment. J Vestib Res 2013;23:113–17
108Shojania, KG, Dixon-Woods, M. Estimating deaths due to medical error: the ongoing controversy and why it matters. BMJ Qual Saf 2017;26:423–8
109Javia, L, Sardesai, MG. Physical models and virtual reality simulators in otolaryngology. Otolaryngol Clin North Am 2017;50:875–91
110Barber, SR, Kozin, ED, Dedmon, M, Lin, BM, Lee, K, Sinha, S et al. 3D-printed pediatric endoscopic ear surgery simulator for surgical training. Int J Pediatr Otorhinolaryngol 2016;90:113–18
111Locketz, GD, Lui, JT, Chan, S, Salisbury, K, Dort, JC, Youngblood, P et al. Anatomy-specific virtual reality simulation in temporal bone dissection: perceived utility and impact on surgeon confidence. Otolaryngol Head Neck Surg 2017;156:1142–9
112Lui, JT, Hoy, MY. Evaluating the effect of virtual reality temporal bone simulation on mastoidectomy performance: a meta-analysis. Otolaryngol Head Neck Surg 2017;156:1018–24
113Won, T-B, Hwang, P, Lim, JH, Cho, S-W, Paek, SH, Losorelli, S et al. Early experience with a patient-specific virtual surgical simulation for rehearsal of endoscopic skull-base surgery. Int Forum Allergy Rhinol 2018;8:5463
114Chan, S, Li, P, Locketz, G, Salisbury, K, Blevins, NH. High-fidelity haptic and visual rendering for patient-specific simulation of temporal bone surgery. Comput Assist Surg (Abingdon) 2016;21:85101
115Scott, DJ, Pugh, CM, Ritter, EM, Jacobs, LM, Pellegrini, CA, Sachdeva, AK. New directions in simulation-based surgical education and training: validation and transfer of surgical skills, use of nonsurgeons as faculty, use of simulation to screen and select surgery residents, and long-term follow-up of learners. Surgery 2011;149:735–44
116Hafford, ML, Van Sickle, KR, Willis, RE, Wilson, TD, Gugliuzza, K, Brown, KM et al. Ensuring competency: are fundamentals of laparoscopic surgery training and certification necessary for practicing surgeons and operating room personnel? Surg Endosc 2013;27:118–26
117Tool Detection and Operative Skill Assessment in Surgical Videos Using Region-Based Convolutional Neural Networks. In: http://arxiv.org/abs/1802.08774 [7 July 2019]

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