Laparoscopic treatment of pyogenic liver abscess caused by fishbone puncture through the stomach wall and into the liver: A case report

Automatic Recognition of Concealed Fish Bones under Laryngoscopy: A Practical AI Model Based on YOLO-V5

BACKGROUND

Fish bone impaction is one of the most common problems encountered in otolaryngology emergencies. Due to their small and transparent nature, as well as the complexity of pharyngeal anatomy, identifying fish bones efficiently under laryngoscopy requires substantial clinical experience. This study aims to create an AI model to assist clinicians in detecting pharyngeal fish bones more efficiently under laryngoscopy.

METHODS

Totally 3133 laryngoscopic images related to fish bones were collected for model training and validation. The images in the training dataset were trained using the YOLO-V5 algorithm model. After training, the model was validated and its performance was evaluated using a test dataset. The model's predictions were compared to those of human experts. Seven laryngoscopic videos related to fish bone were used to validate real-time target detection by the model.

RESULTS

The model trained in YOLO-V5 demonstrated good generalization and performance, with an average precision of 0.857 when the intersection over union (IOU) threshold was set to 0.5. The precision, recall rate, and F1 scores of the model are 0.909, 0.818, and 0.87, respectively. The overall accuracy of the model in the validation set was 0.821, comparable to that of ENT specialists. The model processed each image in 0.012 s, significantly faster than human processing (p < 0.001). Furthermore, the model exhibited outstanding performance in video recognition.

CONCLUSION

Our AI model based on YOLO-V5 effectively identifies and localizes fish bone foreign bodies in static laryngoscopic images and dynamic videos. It shows great potential for clinical application.

LEVEL OF EVIDENCE

3 Laryngoscope, 134:2162-2169, 2024.

[Recurrent bacterial abscess of the left liver lobe caused by a foreign body (fish bone)]

The authors present minimally invasive surgical treatment of recurrent liver abscess caused by migration of fish bone from the upper gastrointestinal tract. Two-stage treatment implied small-caliber transparietal drainage of abscess with evacuation of purulent detritus at the first stage. At the second stage, primary percutaneous approach was transformed into access of sufficient diameter for flexible or rigid optics for visually controlled bone extraction. Foreign body removal through the drainage tube with endoscopic capture under visual control is preferable regarding safety compared to removal under ultrasound and/or X-ray control. Indeed, endoscopic approach is valuable for optimal positioning of the object and prevention of damage to liver parenchyma during extraction.