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 horseness, 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.Under suitable technical and clinical conditions, remote interactive fiber-optic nasopharyngolaryngoscopy (NPL) can be used to evaluate commonly occurring pathologies with a high degree of reliability. A clinical protocol suitable for interactive and store-and-forward fiber-optic NPL is proposed. Additional applications of telemedicine into otolaryngology are outlined, including otoscopy, intra-oral examination, and evaluation of external facial pathology.
