Telemedicine in Audiology. Best practice recommendations from the French Society of Audiology (SFA) and the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL).
OBJECTIVES
Access to diagnosis and treatments for auditory disorders and related pathologies has regressed in France during the COVID-19 pandemic, posing a risk to the patient's chance of recovery. This best practice recommendations guide aims to list the existing technological solutions for the remote examination of a patient with hearing complaint, and to outline their benefits and, where applicable, their limitations.


METHODS
The recommendations were developed both from the clinical experience of the medical experts who drafted the guide, and from an extensive review of the literature dealing with clinical practice recommendations for tele-audiology. Tele-audiometry solutions were identified on the basis of a search engine query carried out in April 2020, prior to verification of their availability on the European market.


RESULTS
Video otoscopy solutions allow for the teletransmission of images compatible with a high-quality diagnosis, either by connecting via internet to a tele-health platform or using a smartphone or a tablet with an iOS or Android operating system. Using the same telecommunication methods, it is possible to remotely conduct a pure-tone audiometry test in accordance with standard practice, a speech-in-quiet or a speech-in-noise audiometry test, as well as objective measures of hearing. Clinical and paraclinical examinations can be accessed by the physician to be interpreted on a deferred basis (asynchronous tele-audiology). Examinations can also be conducted in real time in a patient, at any age of life, as long as a caregiver can be present during the installation of the transducers or the acoumetry. Tele-audiology solutions also find application in the remote training of future healthcare professionals involved in the management of deafness and hearing impairment.


CONCLUSION
Under French law, tele-otoscopy is a medical procedure that is either a tele-expertise (asynchronous adive) or a teleconsultation act (synchronous advice). Subjective and objective evaluation of the patient's hearing functions can be done remotely provided that the listed precautions are respected.
['Thai-Van|H|H|', 'Bakhos|D|D|', 'Bouccara|D|D|', 'Loundon|N|N|', 'Marx|M|M|', 'Mom|T|T|', 'Mosnier|I|I|', 'Roman|S|S|', 'Villerabel|C|C|', 'Vincent|C|C|', 'Venail|F|F|']
D001298:Audiology D001299:Audiometry D003663:Decision Trees D016057:Evoked Potentials, Auditory, Brain Stem D005602:France D006311:Hearing Disorders D006320:Hearing Tests D006801:Humans D017084:Otoacoustic Emissions, Spontaneous D038781:Otoscopy D000068997:Smartphone D017216:Telemedicine D014741:Video Recording
COVID-19 Tele-audiometry Pure-tone audiometry Acoumetry Tele-otoscopy Audiophonology Auditory evoked potentials Cochlear implant Otoacoustic emissions Presbycusis Speech audiometry Virtual reality