key: cord-0698460-p4mir062 authors: Vijayasundaram, S.; Karthikeyan, Padmanabhan; Mehta, Shashwat Datt title: Proficiency of virtual follow-up amongst tinnitus patients who underwent intratympanic steroid therapy amidst COVID 19 pandemic date: 2020-08-15 journal: Am J Otolaryngol DOI: 10.1016/j.amjoto.2020.102680 sha: 60720665837fe4b981a5a9cd39d302f3b4e790dd doc_id: 698460 cord_uid: p4mir062 AIM: The aim of this study was to assess the efficacy and feasibility of virtual follow-up in patients who have undergone intratympanic steroid injection for treatment of tinnitus during COVID-19 pandemic. MATERIALS & METHODS: Twenty-five patients having long-term tinnitus undergoing intratympanic steroid course, were followed up virtually via video calling & telephonic methods and evaluated using Tinnitus handicap inventory scoring over the period of 68 days. RESULTS: 20 out of 25 patients expressed improvement from symptoms (80%) and 5 of the remaining (20%) showed no improvement. However, most of them were inarguably satisfied with this virtual method of follow up and had no reservation in following the similar method of observation in future. CONCLUSION: Virtual follow-up using video calling applications and telephonic call is an efficacious, cost effective and user-friendly method, which can provide accurate post procedural observation while keeping in account the nationwide lockdown during COVID 19 pandemic. Title: Proficiency of Virtual follow-up amongst tinnitus patients who underwent intratympanic steroid therapy amidst COVID 19 Pandemic ABSTRACT: To assess the efficacy and feasibility of virtual follow -up in patients who have undergone intratympanic steroid injectio n for treatment of tinnitus during COVID-19 pandemic. Twenty-five patients having long-term tinnitus undergoing intratympanic steroid course, were followed up virtually via video calling & telephonic methods and evaluated using Tinnitus handicap inventory scoring over the period of 68 days 20 out of 25 patients expressed improvement from symptoms (80%) and 5 of the remaining (20%) showed no improvement. However, most of them were inarguably satisfied with this virtual method of follow up and had no reservation in following the similar method of observation in future. Virtual follow-up using video calling applications and telephonic call is an efficacious, cost effective and user-friendly method, which can provide accurate Telemedicine is an evolving and dynamic subset of modern medicine, which facilitates the doctor-patient encounter without the obligation of physical presence 1 2 . This virtual meet-up helps to overcome barriers such as mobility and distance, which are posing as a predicament during the nationwide lockdown 3 . During the COVID 19 pandemic, we the otorhinolaryngologists, are at an immense risk of exposure to the virus while dealing with the upper airway tract 4 5 . Any contraction of the virus can cost us our own health and even worse the health of our patients that we are catering to 6 . This unprecedented condition called for development of an innovative yet effectual method for following up post procedural patients. Virtual follow-up via Video calls and telephonic calls can provide us a cost effective, patient friendly and most importantly a safer alternative 7 . Thus, ensuring social distancing while providing the patient with utmost care and observation. We are conducting this study on patients who have undergone Intratympanic steroid injections for the treatment of long-term tinnitus 8 . Tinnitus can be explained as perception of a sound in absence of any actual stimuli in a relatively quiet environment 9 . Various treatment modalities have been put into use to decrease the effects of tinnitus. This Intratympanic injection therapy require multiple sittings and regular follow up to closely monitor the progress while detecting any rare complication 10 . Therefore, the much-required follow-up can be ensured on a digital format which is readily accepted by the patients as well. Thus, safety and security of both the doctor and the patient is safeguarded 11 . An observational study was conducted for a period of 68 days, from March 23 rd to May 31 st , encompassing the days of nationwide lockdown in India during COVID 19 pandemic. The Demographic profile including name, phone number and address were acquired from hospital data base after obtaining consent from hospital management. The patients were contacted via tele conferencing methods such as video calling applications and telephonically by PG residents. The symptom of the patients was evaluated using Tinnitus handicap inventory 12 13 (THI) ( Table 1 .1 )and further assessed for any complications. Based on the scores for each patient, plan of action for future was decided. 12 13 J o u r n a l P r e -p r o o f Twenty-five patients who underwent intratympanic steroid therapy for the treatment of tinnitus before the commencement of nationwide lockdown were included in this study. In our study, patients who have undergone 2 sittings of Intratympanic steroid therapy before 23 rd march 2020, were followed up virtually in order to assess the improvement using THI scoring. 20 out of 25 patients showed improvement in our study and were advised to follow behavioral & cognitive therapies. For these 20, next sitting of IT was also on later dates scheduled. 5 showing no improvement were asked to visit us immediately for further evaluation of the underlying cause. Intra-tympanic steroid injection is a commonly practiced procedure used for treating longstanding tinnitus. It's a safe and effective management modality which demands multiple sittings and frequent follow-up. In the given premise of COVID 19 Pandemic, the J o u r n a l P r e -p r o o f rule of thumb is to minimize the physical proximity between the patients and the doctors to avoid unnecessary exposure. Keeping in mind the safety profile of healthcare workers, hospital visits should be limited to emergency basis only. In such an unrivalled situation, technology can help us to overcome the geographical barrier created by the current lockdown policies. Following up patients virtually using video calling applications and telephonic calls can prove to be a handy tool ensuring patient care and safety of healthcare professionals. This method of observation has exhibited wide acceptance and patient satisfaction. 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