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J Zhejiang Univ (Med Sci)  2021, Vol. 50 Issue (2): 205-211    DOI: 10.3724/zdxbyxb-2021-0132
    
Application of medical magnifying loupes in diagnosis of oral mucosal diseases
ZHANG Yuting(),YUAN Peiyang,JIANG Han,QIU Xuemei,WANG Jiongke,LUO Xiaobo,DAN Hongxia,ZHOU Yu,ZENG Xin,JIANG Lu,CHEN Qianming
Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu 610041, China
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Abstract  

Objective: To evaluate the application of medical magnifying loupes in diagnosis of oral mucosal diseases. Methods: Twenty-four patients with plaque-type oral lichen planus or homogeneous oral leukoplakia were inspected by naked eyes or assistance with magnifying loupes. Histopathological results were used as the gold standard to evaluate the sensitivity, specificity and accuracy of the two methods in clinical diagnosis. Questionnaires were used to evaluate the subjective effect of magnifying loupes on the diagnosis efficiency of oral mucosal diseases and to explore the most suitable parameters for application. Results:The sensitivity, specificity and accuracy of medical magnifying loupes for the identification of plaque-type oral lichen planus and homogeneous oral leukoplakia were 94.74%, 100.00% and 95.83%, respectively, which were significantly higher than those of naked eye inspection (89.47%, 80.00% and 87.50%). The effective rate of magnifying loupes assisted diagnosis was 91.76% according to physicians’ subjective evaluation. The most suitable parameters were 3.5 times magnification and 400?mm working distance. Conclusion: The medical magnifying loupes can effectively improve the efficiency of the inspection and diagnosis of oral mucosal diseases, and have the characteristics of convenience and real-time. The recommended clinical parameters are 3.5 times magnification and 400?mm working distance.



Key wordsMedical magnifying loupe      Oral mucosal diseases      Plaque-type oral lichen planus      Homogeneous oral leukoplakia      Auxiliary diagnosis      User experience     
Received: 25 January 2021      Published: 18 June 2021
CLC:  R781.5  
Corresponding Authors: CHEN Qianming     E-mail: 1501379093@qq.com
Cite this article:

ZHANG Yuting,YUAN Peiyang,JIANG Han,QIU Xuemei,WANG Jiongke,LUO Xiaobo,DAN Hongxia,ZHOU Yu,ZENG Xin,JIANG Lu,CHEN Qianming. Application of medical magnifying loupes in diagnosis of oral mucosal diseases. J Zhejiang Univ (Med Sci), 2021, 50(2): 205-211.

URL:

http://www.zjujournals.com/med/10.3724/zdxbyxb-2021-0132     OR     http://www.zjujournals.com/med/Y2021/V50/I2/205


医用放大镜辅助口腔黏膜病临床视诊的价值

目的:研究医用放大镜在提高口腔黏膜病临床诊断效率中的作用及其最适合的临床使用参数。方法:选取24例斑块型口腔扁平苔藓及均质型口腔白斑病病例,以组织病理学检查结果为标准,评价经肉眼视诊和医用放大镜辅助视诊的敏感度、特异度和准确度;以问卷调查方式研究医用放大镜辅助视诊对口腔黏膜病诊断的主观有效率、使用体验并探讨其最适合的临床使用参数。结果:医用放大镜辅助视诊鉴别斑块型口腔扁平苔藓及均质型口腔白斑病的敏感度、特异度、准确度分别为94.74%、100.00%、95.83%,均高于肉眼视诊的敏感度、特异度、准确度(89.47%、80.00%、87.50%)。医生使用的主观评价认为医用放大镜辅助诊断的有效率为91.76%。口腔黏膜病临床诊治最适参数为放大倍数3.5倍,工作距离400?mm。结论:医用放大镜能够有效提高口腔黏膜病的视诊诊断效率,且具有方便、实时的特点。推荐临床使用参数为放大倍数3.5倍,工作距离400?mm。


关键词: 医用放大镜,  口腔黏膜病,  斑块型口腔扁平苔藓,  均质型口腔白斑病,  辅助诊断,  使用体验 

放大镜类型

放大倍数

工作距离(mm)

视场直径(mm)

2.5倍眼镜式放大镜

2.5

350

77

3.5倍头戴式放大镜

3.5

400

86

5倍头戴式放大镜

5.0

300

44

Table 1 Parameters of medical magnifying loupes

病理检查结果

n

肉眼视诊

放大镜辅助诊断

口腔扁平苔藓

口腔白斑病

口腔扁平苔藓

口腔白斑病

口腔扁平苔藓

19

17

2

18

1

口腔白斑病

5

1

4

0

5

合 计

24

18

6

18

6

Table 2 Results of naked eye inspection and medical magnifying loupes to distinguish oral lichen planus and oral leukoplakia
Figure 1 Images of the lesions in patient with oral leukoplakia (case 1)
Figure 2 Images of the lesions in patient with plaque-type oral lichen planus (case 2)
Figure 3 Images of the lesions in patient with erosive oral lichen planus (case 3)
Figure 4 Images of the lesions in patient with pemphigus vulgaris (case 4)
Figure 5 The subjective effectiveness of different medical magnifying loupes in diagnosis
Figure 6 Physician’s experience of using different medical magnifying loupes
Figure 7 Schematic diagrams of naked eye visual acuity angle and the application of medical magnifying loupes to reduce visual acuity angle
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