Department of Otolaryngology-Head and Neck Surgery, Karmanos Cancer Institute & Wayne State University, USA.
Department of Oncology, Karmanos Cancer Institute & Wayne State University, USA.
J Telemed Telecare. 2023 Jun;29(5):331-348. doi: 10.1177/1357633X20985391. Epub 2021 Feb 3.
As the coronavirus 2019 pandemic puts strains on current models of otolaryngology practice, telemedicine is an attractive way for otolaryngologists to reduce in-person appointments while still addressing the health of their patients. This systematic review of the literature aims to identify the evidence basis for using telemedicine in otolaryngology practice to limit person-to-person interactions while achieving comparable quality to in-person services.
The authors gathered articles from three databases (Embase, PubMed and Web of Science), performed a comprehensive literature review of articles published on telemedicine since 2002, and selected articles for inclusion based on their relevance to otolaryngology and the potential of the intervention to improve patient social distancing.
A total of 7153 articles were identified from the initial query. After review, 35 met the inclusion criteria. Of the included articles, 32 (91%), found their specific telemedicine intervention to be effective when compared to in-person services. Twenty articles (57%) were related to remote otoscopy. Other telemedical interventions included videoconferencing for peri-operative visits, diagnosis of peritonsillar abscess, telephone-based voice evaluations and evaluation of nasal fractures.
Video-otoscopy is the most well-supported telemedical intervention which limits physical contact between otolaryngologists and their patients. Other interventions have also demonstrated efficacy but have yet to be as widely validated as video-otoscopy. Telehealth facilitators play a key role in providing high-quality telehealth services. More invasive procedures, such as laryngoscopy, require further evidence to demonstrate definite benefits in a telemedicine setting.
由于 2019 年冠状病毒病大流行给耳鼻喉科目前的实践模式带来压力，远程医疗是耳鼻喉科医生减少面对面预约的一种有吸引力的方式，同时仍能解决患者的健康问题。本系统文献复习旨在确定在耳鼻喉科实践中使用远程医疗的证据基础，以限制人与人之间的接触，同时达到与面对面服务相当的质量。
作者从三个数据库（Embase、PubMed 和 Web of Science）中收集文章，对 2002 年以来发表的关于远程医疗的文章进行全面文献回顾，并根据其与耳鼻喉科的相关性和干预措施改善患者社会隔离的潜力选择纳入文章。
从最初的查询中确定了 7153 篇文章。经过审查，有 35 篇符合纳入标准。在纳入的文章中，32 篇（91%）发现其特定的远程医疗干预与面对面服务相比是有效的。20 篇文章（57%）与远程耳镜检查有关。其他远程医疗干预包括用于围手术期就诊、诊断扁桃体周脓肿、基于电话的语音评估和鼻骨折评估的视频会议。
视频耳镜检查是最受支持的远程医疗干预措施，可以限制耳鼻喉科医生和患者之间的身体接触。其他干预措施也已证明有效，但尚未像视频耳镜检查那样得到广泛验证。远程医疗促进者在提供高质量的远程医疗服务方面发挥着关键作用。需要进一步的证据来证明在远程医疗环境中进行喉镜检查等更具侵入性的程序具有明确的益处。
