A systematic review of remote otological assessment using video-otoscopy over the past 10 years: reliability and applications

Metcalfe, Christopher; Muzaffar, Jameel; Orr, L; Coulson, Chris

doi:10.1007/s00405-020-06596-2

Cited by 15 publications

(19 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For OM, evaluation of the tympanic membrane and the middle ear by a tele-provider is conducted in one of two ways: video microscopy or video otoscopy, the latter of which also often permits pneumatic otoscopy. The exam is carried out by the patient's family or a telemedicine facilitator, and findings may be transmitted to a provider in real-time, or recorded and delivered for interval review (Metcalfe et al, 2021).…”

Section: Telemedicinementioning

confidence: 99%

Otitis Media Practice During the COVID-19 Pandemic

Marom¹,

Pitaro

Shah

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

The global coronavirus disease-2019 (COVID-19) pandemic has changed the prevalence and management of many pediatric infectious diseases, including acute otitis media (AOM). Coronaviruses are a group of RNA viruses that cause respiratory tract infections in humans. Before the COVID-19 pandemic, coronavirus serotypes OC43, 229E, HKU1, and NL63 were infrequently detected in middle ear fluid (MEF) specimens and nasopharyngeal aspirates in children with AOM during the 1990s and 2000s and were associated with a mild course of the disease. At times when CoV was detected in OM cases, the overall viral load was relatively low. The new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen responsible for the eruption of the COVID-19 global pandemic. Following the pandemic declaration in many countries and by the World Health Organization in March 2020, preventive proactive measures were imposed to limit COVID-19. These included social distancing; lockdowns; closure of workplaces; kindergartens and schools; increased hygiene; use of antiseptics and alcohol-based gels; frequent temperature measurements and wearing masks. These measures were not the only ones taken, as hospitals and clinics tried to minimize treating non-urgent medical referrals such as OM, and elective surgical procedures were canceled, such as ventilating tube insertion (VTI). These changes and regulations altered the way OM is practiced during the COVID-19 pandemic. Advents in technology allowed a vast use of telemedicine technologies for OM, however, the accuracy of AOM diagnosis in those encounters was in doubt, and antibiotic prescription rates were still reported to be high. There was an overall decrease in AOM episodes and admissions rates and with high spontaneous resolution rates of MEF in children, and a reduction in VTI surgeries. Despite an initial fear regarding viral shedding during myringotomy, the procedure was shown to be safe. Special draping techniques for otologic surgery were suggested. Other aspects of OM practice included the presentation of adult patients with AOM who tested positive for SARS-2-CoV and its detection in MEF samples in living patients and in the mucosa of the middle ear and mastoid in post-mortem specimens.

show abstract

Section: Telemedicinementioning

confidence: 99%

Otitis Media Practice During the COVID-19 Pandemic

Marom¹,

Pitaro

Shah

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

show abstract

“…Evidence already exists to suggest that remote assessment using telemedicine may be a feasible option in ENT. [8][9][10][11] Indeed, a visual examination of the upper aerodigestive tract, usually in the form of flexible nasendoscopy and oral examination with a headlight, is essential for the assessment of suspected HNC patients. Both the acquisition of high-quality images and the development of technology, which allows secure storage and forwarding of such images facilitates an environment in which senior clinicians can provided a comprehensive clinical assessment entirely remotely.…”

Section: Introductionmentioning

confidence: 99%

Introduction of a novel telescopic pathway to streamline 2‐week‐wait suspected head and neck cancer referrals and improve efficiency: A prospective service evaluation

Metcalfe

Doğan

Glazzard

et al. 2021

Laryngoscope Investig Oto

Self Cite

View full text Add to dashboard Cite

Objectives: This study summarizes the introduction of a novel telescopic pathway, which streamlines 2-week-wait suspected head and neck cancer referrals to our unit, describes the logistics of the pathway, and analyzes referral numbers and outcomes.We also discuss wider issues surrounding remote assessment in head and neck cancer.Methods: Data were collected prospectively between January and May 2021, capturing all 2-week-wait referrals to our unit following the introduction of a telescopic pathway which utilized a nurse-led clinic for nasendoscopic examination of selected patients and consultant-led remote assessment using store and forward technology.Information on referral numbers, waiting times and outcomes was recorded.Results: Three hundred and forty (185 high risk, 155 low risk) patients entered the telescopic pathway with the remaining 74 patients seen on the conventional standard of care pathway. Cancer conversion rates were 17%, <1%, and 5.4% for the high-risk telescopic, low-risk telescopic and standard of care pathways respectively.No patients discharged from the telescopic pathway were re-referred within 3 months. Review capacity for endoscopic examination was higher per consultant on the telescopic pathway versus the standard of care (p = .01). Conclusion:A combination of risk stratification and asynchronous telescopic assessment shows promise for the management of suspected head and neck cancer referrals. Potential benefits include consultant-led care for all patients and enhanced documentation. Digital communication with patients may also assist with adherence to the new NHS 28-day diagnostic standard for cancer referrals. Ongoing data collection is required to assess how the pathway functions over a longer period.

show abstract

“…Otolaryngology faces special challenges in implementing a virtual practice due to physical restriction of endoscopic or cavity inspection as part of the head and neck exam. 19 While there are emerging tools such as remote otoscopy 20 and digital oral cavity examination, 21 these may not be widely available and will have their own learning curve within telehealth for optimal use. However, improvements in the non-clinical barriers, such as patient digital literacy, screening processes, internet resources, and interpretive services, could lead to additional use over time.…”

Section: Discussionmentioning

confidence: 99%

Telehealth Adoption and Perspectives Among Pediatric Otolaryngologists Following the COVID-19 Pandemic

Jones

Saravia

Mamidi

et al. 2022

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objectives: To assess use of and physician experiences with pediatric otolaryngology telehealth visits as impacted by the COVID-19 pandemic. Study Design/Setting: Cross sectional survey. Methods: A 15-question survey was electronically distributed to 656 members of the American Society of Pediatric Otolaryngology in August 2021, addressing member demographics, experiential practice elements, and use pre-pandemic, during the initial shutdown period of March-May 2020, and current use at the time of survey inquiry. Results: There were 124 respondents (response rate = 18.9%). Incident use pre-pandemic and during the shutdown were 21.0% (n = 26), and 92.7% (n = 115), respectively. Current use was 83.9% (n = 104) and the percentage of new current users (79.5%, n = 78) was significant ( P < .0001,95% CI = 70.6%-86.4%). Estimated median telehealth visit rates pre-pandemic, during shutdown, and currently were 0 to 1, 4 to 5, and 2 to 3 per week, respectively ( P < .0001). A difference in post-covid adoption rates was noted only for location ( P = .008), with no differences for years out of training or practice type. Compared to in-person visits, physician satisfaction with telehealth visits was rated equivalent (49.0%) or worse/much worse (48.1%). The most common telehealth uses were follow-up visits (83.7%), pre-operative counseling (76.9%), and post-operative evaluation (69.2%). The need for a detailed exam (89.4%) and initial visits (32.7%) were reasons a telehealth visit was not offered. Conclusions: The COVID-19 pandemic appears to have precipitated a rapid increase in telehealth adoption among surveyed pediatric otolaryngologists, regardless of age or practice type. The most significant limitations remain the need for a detailed exam, perceived low patient technological literacy, and limitations to interpretive services. Technology-based optimization of these barriers could lead to increased use and physician satisfaction.

show abstract

A systematic review of remote otological assessment using video-otoscopy over the past 10 years: reliability and applications

Cited by 15 publications

References 27 publications

Otitis Media Practice During the COVID-19 Pandemic

Otitis Media Practice During the COVID-19 Pandemic

Introduction of a novel telescopic pathway to streamline 2‐week‐wait suspected head and neck cancer referrals and improve efficiency: A prospective service evaluation

Telehealth Adoption and Perspectives Among Pediatric Otolaryngologists Following the COVID-19 Pandemic

Contact Info

Product

Resources

About