Otoendoscopes to Enhance Telemedicine During the COVID-19 Pandemic. (October 2022)

• Record Type: Journal Article
• Authors: Ronner, Evette A.; Stenerson, Matthew E.; Goldschmidt, Nicole H.; Chari, Divya A.; Diercks, Gillian R.; Lee, Daniel J.; Keamy, Donald G.; Mankarious, Leila A.; Cohen, Michael S.
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 131:Number 10(2022)
• Page Start: 1115
• Page End: 1122
• Publication Date: 2022-10
• Subjects: telemedicine -- otoendoscope -- ear exam -- at-home -- otitis media; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/00034894211051810
• Languages: English
• ISSNs: 0003-4894

Abstract

Objectives: As telemedicine has become increasingly utilized during the COVID-19 pandemic, portable otoendoscopy offers a method to perform an ear examination at home. The objective of this pilot study was to assess the quality of otoendoscopic images obtained by non-medical individuals and to determine the effect of a simple training protocol on image quality. Methods: Non-medical participants were recruited and asked to capture images of the tympanic membrane before and after completion of a training module, as well as complete a survey about their experience using the otoendoscope. Images were de-identified, randomized, and evaluated by 6 otolaryngologists who were blinded as to whether training had been performed prior to the image capture. Images were rated using a 5-point Likert scale. Results: Completion of a training module resulted in a significantly higher percentage of tympanic membrane visible on otoendoscopic images, as well as increased physician confidence in identifying middle ear effusion/infection, cholesteatoma, and deferring an in-person otoscopy ( P < .0001). However, even with improved image quality, in most cases, physicians reported that they would not feel comfortable using the images to for diagnosis or to defer an in-person examination. Most participants reported that the otoendoscope was simple to use and that they would feel comfortable paying for the device. Conclusions: At-home otoendoscopes can offer a sufficient view of the tympanic membrane in select cases. The use of a simple training tool can significantly improve image quality, though often not enough to replace an in-person otoscopic exam.