Redesigning the Paradigms of Clinical Practice for Oral and Maxillofacial Surgery in the Era of Lockdown for COVID-19: From Tradition to Telesemeiology

Abstract

The rise of the COVID-19 pandemic has posed new challenges for health care institutions. Restrictions imposed by local governments worldwide have compromised the mobility of patients and decreased the number of physicians in hospitals. Additional requirements in terms of medical staff security further limited the physical contact of doctors with their patients, thereby questioning the traditional methods of clinical examination. Our institution has developed an organization model to translate the essential clinical services into virtual consultation rooms using a telemedicine interface which is commonly available to patients. We provide examples of clinical activity for a maxillofacial surgery department based on teleconsultation. Our experience is summarized and an organization model is drafted in which outpatient consultation offices are translated into virtual room environments. Clinical examples are provided, demonstrating how each subspecialty of oral and maxillofacial surgery can benefit from virtual examinations. The concept of “telesemeiology” is introduced and a checklist is presented to guide clinicians to perform teleconsultations. This paper is intended to provide an organization model based on telemedicine for maxillofacial surgeons and aims to represent an aid for colleagues who are facing the pandemic in areas where lockdown limits the possibility of a physical examination.

Reliability and usability of telemedicine evaluations for facial dystonia

“…High usability scoring from this study is consistent with prior satisfactory teleconsultation reports. 3 , 21 , 22 , 23 Lower grading severity in the later visit in a post hoc subgroup analysis, whether it was telemedicine or in-person visit, could be due to participant familiarity with the examination processes.…”

Clinical signs, telemedicine and online consultations in head and neck diseases during the SARS CoV-2 pandemic: an Italian experience

“…As part of their training, all clinicians were instructed to perform a complete on-line anamnesis and to evaluate visual signs associable to upper airway infections. We created the term ‘telesemiology’ 12 , a novel expression coined to define the group of signs and symptoms detectable through remote clinical inspection performed using technological devices. The reliability of such signs is strongly dependent upon patient collaboration, since they are requested to perform specific tasks in front of the camera, with appropriate lighting and following the instructions of the clinician ( Fig.…”

Reliability and Usability of Telemedicine Evaluations for Facial Dystonia

“…1,2 Lastly, high usability scoring from this study is consistent with prior satisfactory teleconsultation reports. 3,[27][28][29] This study was the rst to investigate telemedicine reliability in the evaluation of both the grading and treatment complications of facial dystonia. The examination protocol of this study should be studied further as a possible future standard.…”