Telemedicine for Patients With Unilateral Sudden Hearing Loss in the COVID-19 Era

Abstract

IMPORTANCE Developing a telemedicine tool to discriminate between patients who need urgent treatment for sudden sensorineural hearing loss (SSNHL) from those who do not takes on special importance during the COVID-19 pandemic.OBJECTIVE To explore the feasibility of a telemedicine model to assist in the evaluation of new-onset unilateral sudden hearing loss (SHL) among patients who do not have access to medical resources, especially during the COVID-19 pandemic.DESIGN, SETTING, AND PARTICIPANTS This prospective cohort investigation of a telemedicine model was conducted at a tertiary referral medical center between May 2020 and January 2021, with the interpreting physician blinded to the results of formal audiograms. The study included a consecutive sample of adult patients (aged Ն18 years) referred to the otolaryngology emergency department in our medical center with the chief complaint of new-onset unilateral SHL. INTERVENTIONSThe telemedicine model comprised 2 sequential steps: a Weber test using the Hum Test and a smartphone-based vibration, and uHear app-based audiometry.MAIN OUTCOMES AND MEASURES Discrimination between patients with and without SSNHL by using the telemedicine model. All diagnoses subsequently confirmed by a formal audiogram.RESULTS Fifty-one patients with new-onset unilateral SHL participated in the study study (median age, 45 [range, 18-76] years; 28 [54.9%] men). The sensitivity and specificity of the telemedicine model for fulfilling the audiometric criteria of SSNHL (loss of Ն30 dB in Ն3 consecutive frequencies) were 100% (95% CI, 84%-100%) and 73% (95% CI, 54%-88%), respectively. The PPV was 72% (95% CI, 53%-87%), the NPV was 100% (95% CI, 85%-100%), and the accuracy was 84.3% (95% CI, 71%-93%). Although 8 participants had false-positive results, all of them had SSNHL that did not meet the full audiometric criteria. CONCLUSIONS AND RELEVANCEThe telemedicine model presented in this study for the diagnosis of SSNHL is valid and reliable. It may serve as a primary tool for the discrimination between patients in need of urgent care for SSNHL from those who are not, especially during the COVID-19 pandemic.

COVID-19 and Sudden Sensorineural Hearing Loss: A Systematic Review

“…In this context, tele-audiometry has become a workable option for audiometric examination, with a high level of accuracy that is not significantly different from traditional audiometric testing ( 41 ). A study by Shilo et al based on smartphone vibration and uHear App hearing tests also confirmed that the telemedicine model for diagnosing SSNHL is valid and reliable ( 42 ). In addition, some improvements can be made to the hearing test technologies to minimize contact with the patient.…”

Software Application toward Accessible Hearing Care Assessment: Gap in Noise Test

“…In addition, large populations in the low economic countries may not have accessibility to hearing care services due to the nancial inability of their health sectors to establish audiology clinics, which require medical devices, furniture, construction, and other overhead costs [4][5][6][7]. An a ordable and accessible alternative to tackle these concerns is using the available technology in smartphones and low-cost sensors [8,9].…”

Audiometry-Confirmed Sudden Sensorineural Hearing Loss Incidence among COVID-19 Patients and BNT162b2 Vaccine Recipients

“…Hearing tests were not routinely conducted, and confirmed COVID-19 patients were even less likely to be sent to undergo audiometric studies. At-home and mobile SSNHL tests have been developed and seem to be reliable but could not eventually replace an objective audiometry ( 18 ).…”