Heneghan C, Sclafani A P, Stern J, Ginsburg J
Department of Electronic and Electrical Engineering, University College Dublin.
IEEE Eng Med Biol Mag. 1999 Jul-Aug;18(4):53-62. doi: 10.1109/51.775489.
Under suitable technical and clinical conditions, remote interactive fiber-optic NPL can be used to evaluate a range of commonly occurring pathologies with a high degree of reliability. A clinical protocol appropriate for interactive and store-and-forward fiber-optic NPL was proposed for further evaluation. Additional applications of telemedicine in otolaryngology were outlined, including otoscopy, intra-oral examination, and evaluation of external facial pathology. We envisage tele-otolaryngology taking place in a variety of ways: Interactions between rural-based PCPs and specialists (routine evaluation of hoarseness, dysphagia), using store-and-forward techniques. Consults from emergency medicine physicians at a general service hospital to a specialist (laryngeal trauma, acute peritonsillar abscess, TM perforations) using interactive means. Case discussions between specialist and sub-specialist using a combination of store-and-forward and interactive technologies. Potentially, there are at least three significant benefits from widespread acceptance of telemedicine in the field of otolaryngology, or indeed in any of the medical specialties: Saved lives and reduced medical costs due to early detection of serious pathology (in this case, head and neck cancers). Reduced unnecessary referrals to specialists, and consequent savings to the patient and health-care insurer, accompanied by more efficient usage of specialist time. Enhanced level of medical education and interaction, as the link between the referring and consulting physician is more immediate and direct [27]. For these reasons, combined with the high number of visits at the primary-care level related to issues in otolaryngology-head and neck surgery, tele-otolaryngology is poised to be a leading telemedicine application within the next few years.
在合适的技术和临床条件下，远程交互式光纤鼻咽镜检查可用于评估一系列常见病变，具有高度可靠性。提出了一种适用于交互式和存储转发光纤鼻咽镜检查的临床方案以供进一步评估。概述了远程医疗在耳鼻喉科的其他应用，包括耳镜检查、口腔检查以及面部外部病变评估。我们设想远程耳鼻喉科将以多种方式开展：农村基层医疗服务提供者与专科医生之间的互动（对声音嘶哑、吞咽困难进行常规评估），采用存储转发技术。综合医院急诊科医生向专科医生进行会诊（喉部创伤、急性扁桃体周围脓肿、鼓膜穿孔），采用交互式方式。专科医生与亚专科医生之间通过存储转发和交互式技术相结合进行病例讨论。在耳鼻喉科领域，实际上在任何医学专科中，广泛接受远程医疗可能至少带来三个显著益处：由于早期发现严重病变（在这种情况下为头颈癌），挽救生命并降低医疗成本。减少不必要的专科转诊，从而为患者和医疗保险公司节省费用，同时更有效地利用专科医生的时间。提高医学教育和互动水平，因为转诊医生和会诊医生之间的联系更加直接和即时[27]。出于这些原因，再加上基层医疗层面与耳鼻喉科 - 头颈外科问题相关的就诊次数众多，远程耳鼻喉科有望在未来几年成为领先的远程医疗应用。
