Audiology Telemedicine Evaluations: Potential Expanded Applications

Abstract

There is underutilization of cochlear implants with delays in implantation linked to distance from implant centers. Telemedicine could connect cochlear implant specialists with patients in rural locations. We piloted telemedicine cochlear implant testing in a small study, largely composed of normal-hearing volunteers to trial this new application of teleaudiology technology. Thirteen subjects (8 with normal hearing and 5 with hearing loss ranging from mild to profound) underwent a traditional cochlear implant evaluation in person and then via telemedicine technology. Routine audiometry, word recognition testing, and Arizona Biological Test (AzBio) and consonant-nucleus-consonant (CNC) testing were performed. Mean (SD) percent difference in AzBio between in-person and remote testing was 1.7% (2.06%). Pure tone average (PTA), speech reception threshold (SRT), and word recognition were similar between methods. CNC testing showed a mean (SD) difference of 6.8% (10.2%) between methods. Testing conditions were acceptable to audiologists and subjects. Further study to validate this method in cochlear implant candidates and a larger population is warranted.

A Review of Telemedicine Applications in Otorhinolaryngology: Considerations During the Coronavirus Disease of 2019 Pandemic

“…15 When assessing the feasibility of remote evaluation of cochlear implant candidacy, Fletcher et al reported comparable testing results across remote and in-person conditions in a within-subject control study. 40 Despite the demonstrated applicability of telemedicine to neurotology, there is documented needs for improvement. Several studies note that a reliable standardized grading scale or diagnostic guide could be of significance in remote evaluation of otitis media to ensure more uniform, standardized assessments.…”

Smartphone‐Based Applications to Detect Hearing Loss: A Review of Current Technology

“…Smartphone‐based hearing assessments may offer an opportunity to screen for ARHL in a low‐cost and easily accessible manner. Various audiometric tests have been shown to produce similar results between in‐person and remote testing modalities 31 . Patients may even prefer mobile‐based self‐administered audiometry to conventional audiometry 32 .…”

“…Various audiometric tests have been shown to produce similar results between in-person and remote testing modalities. 31 Patients may even prefer mobile-based self-administered audiometry to conventional audiometry. 32 This review provides an overview of commercially available smartphone apps that claim to assess hearing.…”

A Review of Contemporary Teleaudiology: Literature Review, Technology, and Considerations for Practicing

“…Also, new audiology patient pathways through online hearing screening and assessment were provided by a free online digit-in-noise test [15]. For CI candidates, routine audiometry, word recognition testing, Arizona Biological test, and consonant-nucleus-consonant test were examined to adapt teleaudiological technology and accepted to audiologists and patients [16]. An interesting development of a self-diagnostic system of a high-frequency audiometer for monitoring the ototoxicity was first described in 2012 and was updated for monitoring cisplatin management of veterans undergoing cancer treatment in 2015 [17].…”

“…Also, new audiology patient pathways through online hearing screening and assessment were provided by a free online digit-in-noise test [ 15 ]. For CI candidates, routine audiometry, word recognition testing, Arizona Biological test, and consonant-nucleus-consonant test were examined to adapt teleaudiological technology and accepted to audiologists and patients [ 16 ].…”