Volume 143, Issue 2 p. 253-257
Original Research-Otology and Neurotology

Preoperative planning for ear surgery using store-and-forward telemedicine

John Kokesh MD

Corresponding Author

John Kokesh MD

Alaska Native Medical Center, Otolaryngology, Anchorage, AK

John Kokesh, MD, ANMC 4315 Diplomacy Drive, Anchorage, AK 99508-5926. E-mail address: [email protected].Search for more papers by this author
A. Stewart Ferguson PhD

A. Stewart Ferguson PhD

Alaska Native Tribal Health Consortium: AFHCAN, Anchorage, AK

Search for more papers by this author
Chris Patricoski MD

Chris Patricoski MD

Alaska Native Tribal Health Consortium: AFHCAN, Anchorage, AK

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First published: 01 August 2010
Citations: 1

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.

Abstract

OBJECTIVE

To determine if store-and-forward telemedicine can be used to accurately plan ear surgery.

STUDY DESIGN

Case series with chart review.

SETTING

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.

RESULTS

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.

CONCLUSION

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.