key: cord-0894280-bpyj4hk8
authors: Meng, Xiangming; Dai, Zhiyong; Hang, Chao; Wang, Yangyang
title: Smartphone-enabled wireless otoscope-assisted online telemedicine during the COVID-19 outbreak
date: 2020-04-04
journal: Am J Otolaryngol
DOI: 10.1016/j.amjoto.2020.102476
sha: fe91e84d882ca8d23eac47b39efdb4478a6b63dd
doc_id: 894280
cord_uid: bpyj4hk8

nan

J o u r n a l P r e -p r o o f Smartphone-enabled wireless otoscope-assisted online telemedicine during the

Dear Editor:

Coronavirus disease 2019 (COVID-19), a new infectious disease in humans, is characterized by respiratory symptoms and human-to-human transmission [1] . The number of the confirmed cases of COVID-19 is rising sharply, and the World Health Organization (WHO) has declared that it can be considered as a pandemic on March 1, 2020 [2] . COVID-19 epidemic has caused disastrous consequences all over the world.

As of March 30, 2020, WHO reports that 693224 people have been diagnosed with COVID-19 worldwide, with 33106 deaths, including 200 countries and territories, and 82447 of these cases in China [3] .

As an integral part of the respiratory system, the nasal cavity and throat may become susceptible to the virus infection. Swabs sampled from the mid-turbinate, nasopharyngeal, and throat of the COVID-19 patients have been detected the 2019 novel coronavirus, with a higher viral load in the nose [4] . Therefore, the department of otolaryngology is considered to be a high-risk department for COVID-19 [5] .

Disasters and pandemics present extraordinary challenges for the healthcare system [6] .

During the rampant spread of COVID-19, most hospitals have suspended routine otolaryngology outpatient services in China, retaining only emergency services. Some clinics also shuttered their doors and delivering services only via the non-contact method in the USA [7] . Local health authorities recommend medical care online to J o u r n a l P r e -p r o o f meet people's medical needs. The current COVID-19 pandemic reminds us of the importance of telemedicine to prevent cross-contamination [8] .

Telemedicine in otolaryngology has a long history [9] . However, otolaryngology is under a complicated anatomical structure. Lacking specialized medical expertise, many patients can not clarify their clinical signs and symptoms accurately. As a result, otolaryngologists sometimes have to make a diagnosis online or even give therapeutic advice in minimal information, resulting in an inadequate diagnosis.

With the increased popularity of smartphones, the smartphone application is increasing in otolaryngology clinical practice [10] . The smartphone-enabled otoscope(SEO) is emerging a new electronic device in recent years. Using this device with a dedicated application, doctors can quickly investigate the patient's external auditory canal and tympanic membrane. Previous studies have shown the value of the portable devices not only as a convenient diagnostic aid but also as a teaching adjunct for the pre-clinical medical students [11, 12] . However, smartphone-enabled wireless otoscope-assisted online telemedicine (SEWOAOT) has not been explored during the COVID-19 outbreak. To contain an epidemic, most people like to stay at home and try to minimize going out. Also, a proportion of people have quarantined in an isolation centre or their home for medical observation. In these situations, instead of the traditional otoscope [12] . They found that the students were more confident in identifying the anatomical landmarks of the middle ear. However, a recent study had shown that it had not proved the effectiveness of SEO when local health care workers were examining the children. It potentially relates to insufficient training and education of local medical personnel [13] . 

Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia

World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19

World Health Organization

SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients

The Covid-19 pandemic and otolaryngology: What it comes down to?

Virtually Perfect? Telemedicine for Covid-19

Remote Treatment Delivery in Response to the COVID-19 Pandemic

Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19)

Telemedicine in otolaryngology

Development and face validation of a Virtual Reality Epley Maneuver System (VREMS) for home Epley treatment of benign paroxysmal positional vertigo: A randomized, controlled trial

A cross-sectional evaluation of the validity of a smartphone otoscopy device in screening for ear disease in Nepal

Utility of a smartphone-enabled otoscope in the instruction of otoscopy and middle ear anatomy

Smartphone otoscopy by non-specialist health workers in rural Greenland: A cross-sectional study