Experience with Telemedicine in a Tertiary Academic Otologic Clinic During the COVID-19 Pandemic.

OBJECTIVE: To examine the utility of telemedicine in a tertiary otologic practice. STUDY DESIGN: Retrospective case series. SETTING: Tertiary neurotology clinic. PATIENTS: Consecutive adult patients presenting via video visit between January 2020 and January 2021. INTERVENTIONS: Televideo modality to conduct visits with patients seeking evaluation for new concerns, second opinions, or routine follow-up for established conditions. MAIN OUTCOME MEASURES: Success of the televideo visit defined by the televideo visit being sufficient for determining a definitive plan and not requiring deferment of recommendations for a subsequent in-person visit. RESULTS: A total of 102 televideo visits were performed among 100 unique patients. Of those, 92 (90.2%) visits were for second opinions or evaluation of new concerns, most commonly for vestibular schwannoma (n = 32, 31.4%), followed by sensorineural hearing loss (n = 20, 19.6%). Other visits were conducted for early postoperative follow-up and established general follow-up. In 91.2% of cases (n = 93), patients were successfully evaluated and provided recommendations from the initial video visit. All visits with patients having a diagnosis of meningioma (n = 7), and nearly all with vestibular Schwannoma (97%, n = 31) and sensorineural hearing loss (95%, n = 19) were successful. Of the 79 patients offered surgery as one potential treatment option, 31 patients underwent surgery at our institution by time of review. Patients with unsuccessful visits (n = 9, 8.8%) were advised to schedule additional in-person diagnostic imaging, vestibular testing, or cochlear implant candidacy evaluation to establish a more definitive care plan. CONCLUSION: Virtual televideo visits were successful for a high percentage of selected patients seen at a tertiary neurotology practice, particularly those seeking evaluation of vestibular schwannoma or sensorineural hearing loss.

Telemedicine evaluation of new head and neck patients at a tertiary academic clinic during the coronavirus disease 2019 pandemic.

INTRODUCTION: Coronavirus disease 2019 accelerated the use of virtual visits within health care. We examined the utility of telemedicine for conducting visits in a tertiary head and neck practice. METHODS: A retrospective study was conducted on patients presenting via video to a tertiary-level head and neck clinic between January 2020 and December 2020. Patient demographics were collected in addition to visit indication, diagnostic imaging/tests at the time of visit, and post-visit plan. Visits were deemed successful if evaluation by video was sufficient in determining a clinical plan and did not require deferment of recommendations for subsequent in-person consult visits and/or work-up (labs, imaging). Logistic regression was performed to identify variables that served as significant predictors of successful video visits. RESULTS: A total of 124 video visits were reviewed. Video visits were successful for the initial evaluation 88.7% of the time (n = 110). Computerized tomographic scans were the most available diagnostic test, available for 54% of patients (n = 67), followed by biopsy report 30.6% (n = 38). Visit indication had a statistically significant effect on whether a treatment plan could be made (p = 0.024). For new patients with parotid masses (n = 42), definitive treatment plans could be made 97.6% of the time (n = 41). Patients presenting with an indication of thyroid mass (odds ratio: 0.19 (confidence interval: 0.00072-0.50), p = 0.018) and other neck mass (odds ratio: 0.035 (confidence interval: 0.0014, 0.90), p = 0.043) were at significantly lesser odds than parotid patients to have a successful video visit. DISCUSSION: In this study, virtual visits were successful for a high percentage of head and neck visits, particularly among patients seeking evaluation for parotid-related concerns.