Preoperative planning for ear surgery using store-and-forward telemedicine
No sponsorships or competing interests have been disclosed for this article.
Author Contribution: John Kokesh, conception, design, acquisition and/or analysis of data, writing, intellectual content, and final approval; A. Stewart Ferguson, conception, design, acquisition and/or analysis of data, writing, intellectual content, and final approval; Chris Patricoski, conception, design, acquisition and/or analysis of data, writing, intellectual content, and final approval.
Disclosures: Competing interests: None. Sponsorships: None.
To determine if store-and-forward telemedicine can be used to accurately plan ear surgery.
Case series with chart review.
Tertiary care hospital.
SUBJECTS AND METHODS
Charts were reviewed for elective major ear surgeries resulting from telemedicine referrals during a 13-month period. The store-and-forward telemedicine referrals (electronic consultations) included clinical history, digital images, and audiology data. Consultants reviewed each telemedicine case and documented the recommended surgery and estimated operative time. These charts were matched with patients seen in person during a standard evaluation and had identical surgeries recommended. For the telemedicine evaluation and in-person evaluation groups, the recommended surgeries were compared with actual surgeries performed and the estimated time was compared with the actual operative time.
Forty-five ear surgeries were recommended by the telemedicine evaluation and were matched with 45 surgeries from the standard evaluation and included tympanoplasty with or without canalplasty, mastoidectomy, stapes surgery, and myringoplasty. Telemedicine and in-person evaluation accurately predicted the surgery 89 percent and 84 percent of the time, respectively. The average difference of “actual time” and “estimated time” for the actual surgical procedures performed was not statistically different between the two groups: 32 minutes for the telemedicine evaluation group and 35 minutes for the in-person evaluation group.
Store-and-forward telemedicine is as effective as in-person evaluation for planning elective major ear surgery.
© 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
- 1, , . Teleconsultation of patients with otorhinolaryngolic conditions. Arch Otolaryngol Head Neck Surg 1994; 120: 133–6.
- 2, , , et al. Overview of telemedicine applications for otolaryngololgy. Laryngoscope 1999; 109: 1433–7.
- 3, , , et al. Validation of teleotology to diagnose ear disease in children. Int J Pediatr Otolaryngol 2005; 69: 739–44.
- 4, , et al. A comparison of in-person examination and video otoscope imaging for tympanostomy tube follow-up. Telemed J E Health 2003; 9: 331–4.
- 5, , . Telehealth in Alaska: delivery of health care services from a specialist's perspective. Int J Circumpolar Health 2004; 63: 387–400.
- 6, , , et al. Digital images for postsurgical follow-up of tympanostomy tubes in remote Alaska. Otolaryngol Head Neck Surg 2008; 139: 87–93.
- 7, , , et al. Telemedicine applications in otolaryngology. IEEE Eng Med Biol Mag 1999; 18: 53–62.
- 8, , , et al. Teleotology: planning, design, development and implementation. J Telemed Telecare 2002; 8: 314–7.
- 9, , , et al. Trends in otitis media and myringtomy with tube placement among American Indian/Alaska Native children and the US general population of children. Pediatr Infect Dis J 2008; 28: 102–7.
- 10, . The regular practice of telemedicine. Arch Otolaryngol Head Neck Surg 2001; 127: 333–5.
- 11, , , et al. Telemedicine applications in otolaryngology. J Telemed Telecare 1998; 4: 74–5.
- 12, , , et al. Realtime telemedicine for paediatric otolaryngology pre-admission screening. J Telemed Telecare 2005; 11: 286–9.
- 13, , , et al. Use of mobile low bandwidth telemedicine techniques for extreme telemedicine applications. J Am Coll Surg 1999; 189: 397–404.
- 14, , , et al. Low bandwidth telemedicine for pre-and postoperative evaluation in mobile surgical services. J Telemed Telecare 2005; 11: 191–3.
- 15, , , et al. Telemedicine to integrate intermittent surgical services into primary care. Telemed J E Health 2002; 8: 131–7.
- 16, , , et al. Practice of otolaryngology via telemedicine. Laryngoscope 1998; 108: 1–7.
- 17, . Telemedicine in otolaryngology. Am J Otolaryngol 2002; 23: 35–43.