Telemedicine allows for the remote delivery of patient care and has been found to have a wide range of uses in otolaryngology. In order to achieve best practices in telemedicine, a platform must be effective and both patients and providers must be satisfied with the use of technology. As telemedicine becomes more widely used in otolaryngology clinics, particularly in the face of the current COVID-19 pandemic, it is important to assess its applicability in this field. The goal of this study was to evaluate existing literature on telemedicine and assess overall image quality, diagnostic concordance, and patient and provider satisfaction with telemedicine technologies.
Methods:
A systematic review was conducted on PubMed and MEDLINE according to the PRISMA 2009 guidelines for articles from 1982 to 2019 relating to telemedicine in otolaryngology. English language studies with primary or secondary endpoints pertaining to image quality, diagnostic concordance, or patient or provider satisfaction were included. Descriptive studies, editorials, and literature reviews were excluded.
Results:
A total of 32 studies were included in our review. Studies assessing imaging quality and diagnostic concordance reported adequate results but with some heterogeneity. Patient and provider satisfaction were consistently high.
Conclusions:
The literature supports telemedicine delivery of otorhinolaryngologic care as having achieved high rates of patient and provider satisfaction with adequate image quality and heterogeneity in diagnostic concordance. Variability in diagnostic accuracy was reported, but appears improved given proper clinical context. More standardized studies are needed specific to telemedicine in the field of otolaryngology.
GarritanoFGGoldenbergD. Successful telemedicine programs in otolaryngology. Otolaryngol Clin North Am. 2011;44(6):1259-1274, vii.
2.
VickeryTWWeteringsRCabrera-MufflyC. Geographic distribution of otolaryngologists in the United States. Ear Nose Throat J. 2016;95(6):218-223.
3.
HofstetterPJKokeshJFergusonASHoodLJ. The impact of telehealth on wait time for ENT specialty care. Telemed J E Health. 2010;16(5):551-556.
4.
XuCQSmithACScuffhamPAWoottonR. A cost minimisation analysis of a telepaediatric otolaryngology service. BMC Health Serv Res. 2008;8(1):30.
5.
KokeshJFergusonASPatricoskiCLeMasterB. Traveling an audiologist to provide otolaryngology care using store-and-forward telemedicine. Telemed J E Health. 2009;15(8):758-763.
6.
UrquhartACAntoniottiNMBergRL. Telemedicine—an efficient and cost-effective approach in parathyroid surgery. Laryngoscope. 2011;121(7):1422-1425.
7.
PhilipsRSeimNMatrkaL, et al. Cost savings associated with an outpatient otolaryngology telemedicine clinic. Laryngoscope Investig Otolaryngol. 2019;4(2):234-240.
8.
BiagioLSwanepoel deWLaurentCLundbergT. Video-otoscopy recordings for diagnosis of childhood ear disease using telehealth at primary health care level. J Telemed Telecare. 2014;20(6):300-306.
9.
BiagioLSwanepoel deWAdeyemoAHallJWIIIVinckB. Asynchronous video-otoscopy with a telehealth facilitator. Telemed J E Health. 2013;19(4):252-258.
10.
LundbergTWestmanGHellstromSSandstromH. Digital imaging and telemedicine as a tool for studying inflammatory conditions in the middle ear—evaluation of image quality and agreement between examiners. Int J Pediatr Otorhinolaryngol. 2008;72(1):73-79.
11.
EikelboomRHMbaoMNCoatesHLAtlasMDGallopMA. Validation of tele-otology to diagnose ear disease in children. Int J Pediatr Otorhinolaryngol. 2005;69(6):739-744.
12.
MbaoMNEikelboomRHAtlasMDGallopMA. Evaluation of video-otoscopes suitable for tele-otology. Telemed J E Health. 2003;9(4):325-330.
13.
SternJHeneghanCSclafaniAPGinsburgJSabiniPDolitskyJN. Telemedicine applications in otolaryngology. J Telemed Telecare. 1998;4(suppl 1):74-75.
14.
FurukawaMFurukawaMKMizojiriGMatsudaH. Telemedicine in laryngology. Telemed J. 1998;4(4):329-333.
15.
YulzariRBretlerSAvrahamYSharabi-NovAEven-TovEGilbeyP. Mobile technology-based real-time teleotolaryngology care facilitated by a nonotolaryngologist physician in an adult population. Ann Otol Rhinol Laryngol. 2018;127(1):46-50.
16.
ShahMUSohalMValdezTAGrindleCR. iPhone otoscopes: currently available, but reliable for tele-otoscopy in the hands of parents?Int J Pediatr Otorhinolaryngol. 2018;106:59-63.
17.
SeimNBPhilipsRHWMatrkaLA, et al. Developing a synchronous otolaryngology telemedicine clinic: prospective study to assess fidelity and diagnostic concordance. Laryngoscope. 2018;128(5):1068-1074.
18.
WuCJWuSYChenPCLinYS. An innovative smartphone-based otorhinoendoscope and its application in mobile health and teleotolaryngology. J Med Internet Res. 2014;16(3):e71.
19.
LundbergTBiagioLLaurentCSandstromHSwanepoel deW. Remote evaluation of video-otoscopy recordings in an unselected pediatric population with an otitis media scale. Int J Pediatr Otorhinolaryngol. 2014;78(9):1489-1495.
20.
SmithACDowthwaiteSAgnewJWoottonR. Concordance between real-time telemedicine assessments and face-to-face consultations in paediatric otolaryngology. Med J Aust. 2008;188(8):457-460.
21.
KokeshJFergusonASPatricoskiC, et al. Digital images for postsurgical follow-up of tympanostomy tubes in remote Alaska. Otolaryngol Head Neck Surg. 2008;139(1):87-93.
22.
PatricoskiCKokeshJFergusonAS, et al. A comparison of in-person examination and video otoscope imaging for tympanostomy tube follow-up. Telemed J E Health. 2003;9(4):331-344.
23.
UllahRGillilandDAdamsD. Otolaryngology consultations by real-time telemedicine. Ulster Med J. 2002;71(1):26-29.
24.
StalforsJEdstromSBjork-ErikssonTMerckeCNymanJWestinT. Accuracy of tele-oncology compared with face-to-face consultation in head and neck cancer case conferences. J Telemed Telecare. 2001;7(6):338-343.
25.
SclafaniAPHeneghanCGinsburgJSabiniPSternJDolitskyJN. Teleconsultation in otolaryngology: live versus store and forward consultations. Otolaryngol Head Neck Surg. 1999;120(1):62-72.
26.
RimmerRAChristopherVFalckA, et al. Telemedicine in otolaryngology outpatient setting-single Center Head and Neck Surgery experience. Laryngoscope. 2018;128(9):2072-2075.
27.
WallLRWardECCartmillBHillAJPorcedduSV. Examining user perceptions of SwallowIT: A pilot study of a new telepractice application for delivering intensive swallowing therapy to head and neck cancer patients. J Telemed Telecare. 2017;23(1):53-59.
28.
BurnsCLWardECHillAJ, et al. A pilot trial of a speech pathology telehealth service for head and neck cancer patients. J Telemed Telecare. 2012;18(8):443-446.
29.
HeadBAKeeneyCStudtsJLKhayatMBumpousJPfeiferM. Feasibility and acceptance of a telehealth intervention to promote symptom management during treatment for head and neck cancer. J Support Oncol. 2011;9(1):e1-e11.
30.
MishraAKapoorLMishraSK. Post-operative care through tele-follow up visits in patients undergoing thyroidectomy and parathyroidectomy in a resource-constrained environment. J Telemed Telecare. 2009;15(2):73-76.
31.
van den BrinkJLMoormanPWde BoerMFPruynJFVerwoerdCDvan BemmelJH. Involving the patient: a prospective study on use, appreciation and effectiveness of an information system in head and neck cancer care. Int J Med Inform. 2005;74(10):839-849.
32.
StalforsJHolm-SjogrenLSchwielerATornqvistHWestinT. Satisfaction with telemedicine presentation at a multidisciplinary tumour meeting among patients with head and neck cancer. J Telemed Telecare. 2003;9(3):150-155.
33.
MadeCCarleLSoderbergOHellstromS. Tele-otolaryngology consultations between two rural primary-care centres in southern Lapland and the University Hospital of Umea. J Telemed Telecare. 1999;5(suppl 1):S93-S94.
34.
PedersenSHolandU. Tele-endoscopic otorhinolaryngological examination: preliminary study of patient satisfaction. Telemed J. 1995;1(1):47-52.
35.
KohlertSMurphyPTseDLiddyCAfkhamAKeelyE. Improving access to otolaryngology-head and neck surgery expert advice through eConsultations. Laryngoscope. 2018;128(2):350-355.
36.
MelcerTHunsakerDCrannBCaolaLDenistonW. A prospective evaluation of ENT telemedicine in remote military populations seeking specialty care. Telemed J E Health. 2002;8(3):301-311.
37.
KokeshJFergusonASPatricoskiC. Preoperative planning for ear surgery using store-and-forward telemedicine. Otolaryngol Head Neck Surg. 2010;143(2):253-257.
38.
BarghouthiTGlynnFSpeakerRBWalshM. The use of a camera-enabled mobile phone to triage patients with nasal bone injuries. Telemed J E Health. 2012;18(2):150-152.
39.
BrantJALeahyKMirzaN. Diagnostic utility of flexible fiberoptic nasopharyngolaryngoscopy recorded onto a smartphone: a pilot study. World J Otorhinolaryngol Head Neck Surg. 2018;4(2):135-139.
40.
EikelboomRHWeberSAtlasMDDinhQMbaoMNGallopMA. A tele-otology course for primary care providers. J Telemed Telecare. 2003;9(suppl 2):S19-S22.
41.
NittariGKhumanRBaldoniS, et al. Telemedicine practice: review of the current ethical and legal challenges [published online February 12, 2020]. Telemed J E Health. doi: 10.1089/tmj.2019.0158.
