Preoperative planning for ear surgery using store-and-forward telemedicine

OBJECTIVE: To determine if store-and-forward telemedicine can be used to accurately plan ear surgery. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care hospital. SUBJECTS AND METHODS: Charts were reviewed for elective major ear surgeries resulting from telemedicine referrals during a 13-month period. The store-and-forward telemedicine referrals (electronic consultations) included clinical history, digital images, and audiology data. Consultants reviewed each telemedicine case and documented the recommended surgery and estimated operative time. These charts were matched with patients seen in person during a standard evaluation and had identical surgeries recommended. For the telemedicine evaluation and in-person evaluation groups, the recommended surgeries were compared with actual surgeries performed and the estimated time was compared with the actual operative time. RESULTS: Forty-five ear surgeries were recommended by the telemedicine evaluation and were matched with 45 surgeries from the standard evaluation and included tympanoplasty with or without canalplasty, mastoidectomy, stapes surgery, and myringoplasty. Telemedicine and in-person evaluation accurately predicted the surgery 89 percent and 84 percent of the time, respectively. The average difference of "actual time" and "estimated time" for the actual surgical procedures performed was not statistically different between the two groups: 32 minutes for the telemedicine evaluation group and 35 minutes for the in-person evaluation group. CONCLUSION: Store-and-forward telemedicine is as effective as in-person evaluation for planning elective major ear surgery. (C) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.