Interdisciplinary Telemedicine in the Management of Dysphagia in Head and Neck

Abstract

The study considered the feasibility and impact of interdisciplinary telemedicine discussions in the management of post-treatment dysphagia in patients with head and neck tumors. This is a retrospective analysis of patients with persistent dysphagia after treatment for head and neck pathology, at an institute in India. The cases were discussed in the telemedicine meeting conducted between host institute and a second unit in the United States. A monthly meeting was organized, using an internet-based video conference system. The ongoing swallowing problems and management were presented, and through discussions, a plan for further management was formulated and carried out. The Functional Oral Intake Scale (FOIS) was measured before and after the implementation of the plan. Twenty-six patients were discussed, out of which, 22 were head and neck malignancies. The recommendations concurred with that of the host unit in 18, differed for three and additive in five patients. The pre-treatment mean FOIS was 1.46 with a standard deviation of 0.989 and post-treatment mean improved to 3.92 with a standard deviation of 1.809 (p < 0.0001). The present study supports the success of an interdisciplinary telemedicine meeting to manage difficult cases of dysphagia in head and neck. The outcome in terms of the FOIS score improved significantly after implementing them. In addition to the direct patient benefits, the meeting helped to facilitate interdepartmental collaboration between two units treating similar sets of patients across the globe, in specialized clinical areas like dysphagia management.

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“…The TM has revolutionized the way we deliver health care in India specially in the context of CIVID-19 with a need to avoid 'Face to face' consultation and thus reduce the risk of disease transmission [6,8] and its applications have been applied in other specialities like endocrinology, oncology care and ophthalmology [6,12,13]. In chronic diseases such as diabetes and hypertension it allows remote monitoring [14].…”

Telemedicine, Patient Satisfaction, and Chronic Rhinosinusitis Care in the Era of COVID-19

“…There has been promising data demonstrating consistency in diagnosis and management for remotely managed patients for dysphagia. 29 These studies, however, were able to incorporate pre-recorded videos and examinations for remote comprehensive review in a collaborative system between different countries. Certain types of otolaryngologic encounters may be more appropriate to manage via telemedicine application versus others, as previously described.…”

Telemedicina y pediatría en la pandemia de COVID-19

“…La TM ha revolucionado la forma en que se brinda auxilio médico en éste y en otros países, especialmente en el contexto de la COVID-19, con la necesidad de prescindir de la consulta "cara a cara" y, por lo tanto, reducir el riesgo de transmisión de enfermedades. 6,9,10 Se ha aplicado en otras especialidades como endocrinología, asistencia oncológica y oftalmología. 10,11 En dolencias crónicas, como la diabetes y la hipertensión, permite la monitorización remota.…”