Using telemedicine to facilitate social distancing in otolaryngology: A systematic review

Abstract

Objectives As the coronavirus 2019 pandemic puts strains on current models of otolaryngology practice, telemedicine is an attractive way for otolaryngologists to reduce in-person appointments while still addressing the health of their patients. This systematic review of the literature aims to identify the evidence basis for using telemedicine in otolaryngology practice to limit person-to-person interactions while achieving comparable quality to in-person services. Methods The authors gathered articles from three databases (Embase, PubMed and Web of Science), performed a comprehensive literature review of articles published on telemedicine since 2002, and selected articles for inclusion based on their relevance to otolaryngology and the potential of the intervention to improve patient social distancing. Results A total of 7153 articles were identified from the initial query. After review, 35 met the inclusion criteria. Of the included articles, 32 (91%), found their specific telemedicine intervention to be effective when compared to in-person services. Twenty articles (57%) were related to remote otoscopy. Other telemedical interventions included videoconferencing for peri-operative visits, diagnosis of peritonsillar abscess, telephone-based voice evaluations and evaluation of nasal fractures. Conclusions Video-otoscopy is the most well-supported telemedical intervention which limits physical contact between otolaryngologists and their patients. Other interventions have also demonstrated efficacy but have yet to be as widely validated as video-otoscopy. Telehealth facilitators play a key role in providing high-quality telehealth services. More invasive procedures, such as laryngoscopy, require further evidence to demonstrate definite benefits in a telemedicine setting.

Remote Triage Incorporating Symptom-Based Risk Stratification for Suspected Head and Neck Cancer Referrals: A Prospective Population-Based Study

“…3 Part of the shift in practice included a sharp uplift in the use of telemedicine in place of face-to-face outpatient appointments. 4,5 Patients referred from primary care to secondary care with suspected head and neck cancer (HNC) are at particular risk of harm from changes to the standard-of-care diagnostic pathway. In normal times, physical examination, combined with flexible transnasal endoscopy of the upper aerodigestive tract where indicated, is considered an essential facet of the new patient evaluation.…”

Remote triage incorporating symptom‐based risk stratification for suspected head and neck cancer referrals: A prospective population‐based study

“…3 Part of the shift in practice included a sharp uplift in the use of telemedicine in place of face-to-face outpatient appointments. 4,5 Patients referred from primary care to secondary care with suspected head and neck cancer (HNC) are at particular risk of harm from changes to the standard-of-care diagnostic pathway. In normal times, physical examination, combined with flexible transnasal endoscopy of the upper aerodigestive tract where indicated, is considered an essential facet of the new patient evaluation.…”

Pediatric otolaryngology telemedicine amid a pandemic – And beyond

“…More specifically, the literature has expanded on the implementation and satisfaction in otolaryngology telemedicine [ 6 , 16 ] [ [6] , [16] , [17] , [18] ] [ [6] , [16] , [17] , [18] ]. A systematic review by Moentmann et al found that out of 35 articles that met inclusion, 32 (91.4%) of them had an effective telemedicine platform, compared to in-person appointments [ 19 ]. Darr et al performed a retrospective review of a satisfaction survey given from mid-March to mid-June 2020 called the modified pediatric otolaryngology telemedicine satisfaction survey (POTSS) [ 20 ].…”