Early Experience With Telemedicine in Patients Undergoing Otologic/Neurotologic Procedures

Abstract

Objective: Compare outcomes for patients who were seen via telemedicine visits after otology/neurotology surgical procedures with those who were seen in traditional office visits. Study Design: Retrospective case review. Setting: Tertiary care academic medical center. Patients: Inclusion criteria were patients who underwent otologic/neurotologic surgery and were seen in at least one telemedicine visit for postoperative care. Intervention (s): Telemedicine visit for postoperative care. Main Outcome Measure (s): Comparison of the number of patient calls, unplanned visits, and delayed complications between telemedicine patients and controls matched for age, procedure, and American Society of Anesthesiologists (ASA) status. Results: Eighteen patients were seen in telemedicine visits postoperatively after the following otologic/neurotologic surgical procedures: cochlear implant surgery (10), vestibular schwannoma resection (4), combined middle fossa and transmastoid cerebrospinal fluid (CSF) leak repair (2), middle fossa repair of superior canal dehiscence (1), and stapedectomy (1). All telehealth visits were for the second postoperative visit. The mean number of patient calls after surgery was 2.3 for the telemedicine group and 1.9 for matched controls which was not a statistically significant difference (p = 0.466). Both groups each had two patients who went to the emergency room, with one in each group being admitted. There was one delayed complication in the control group. Conclusion: Our preliminary experience suggests telemedicine may be used safely in caring for patients after otologic/neurotologic surgery, though it may be associated with more patient phone calls. Further study and experience, including assessing patient satisfaction, will clarify the future role of telemedicine in otology and neurotology.

Utility of Telemedicine for Diagnosis and Management of Laryngology‐Related Complaints during COVID‐19

“…This is the first study to investigate the diagnosis and management concordance rates between the pre‐laryngoscopy telemedicine visits and post‐laryngoscopy in‐person visits for laryngology‐related complaints. Previous studies have assessed the accuracy of diagnosis based on history and specific exam findings available via telemedicine on various otolaryngological complaints ranging from otologic conditions (based on video‐otoscopy images), 15 , 16 , 18 , 19 , 20 , 29 , 30 , 31 , 32 , 33 peritonsillar abscess (based on phone captured intraoral images), 21 nasal fracture (based on phone captured face images), 14 , 34 and dysphonia (based on telephone voice) 35 , 36 and other general otolaryngology consults from general practitioners. 17 , 22 , 37 , 38 , 39 The diagnostic concordance rates from these studies were overall high between 64% and 100%.…”

Surgical Patient Experience with a Novel Telemedicine Program in the COVID-19 Era

“…Prior publications studied the application of telemedicine to a single visit type and focused primarily on postoperative care. 3,5,[37][38][39][40][41]42 As the transition to telemedicine visits was not voluntary for patients at our institution during the COVID-19 pandemic, the study population is not biased either toward or against virtual interactions, whereas many other studies required patients to "opt-in" to the telemedicine program. This study has good external validity regarding the ability of patients to obtain a suitable device and set up the telemedicine visit as devices or training to conduct the appointment were not supplied to patients in this study.…”

Adherence to Long‐Term Follow‐up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation

“…22 Prior to the pandemic, barriers to incorporation of telehealth included insurance reimbursement and privacy concerns and lack of institutional telehealth services; however, these have been largely overcome, and telehealth is being incorporated into neurotology care. 23,24 Telehealth visits are particularly well suited for imaging surveillance of SVS, where the physical exam plays a smaller role in decision making. Patients can locally undergo an MRI, which can be reviewed with the patient over the telehealth platform.…”