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The COVID-19 crisis has impacted how ENT care is delivered. Amongst the significant upheaval, it has also been a time of great innovation and several opportunities have emerged to address longstanding issues in both the delivery of care and organisation of services.

One example of this involves using novel medical technology to deliver patient care at the bedside. Earlier this year, an 80-year-old patient with cholesteatoma was being managed conservatively with regular microsuction due to his significant comorbidities. Just after ENT UK had issued emergency COVID-19 measures in response to lockdown, he was admitted onto the respiratory ward with pneumonia. He was troubled by his discharging ear but concomitantly was too unwell to attend clinic and was also on the high-risk list for COVID.

Mr Joseph Manjaly, Consultant Otologist, Hearing Implant & ENT Surgeon, RNENTED London,
and Miss Lilia Dimitrov, Specialty Registrar and Academic Clinic Fellow in ENT, RNENTED London.

The problem was resolved with the TympaHealth Device, an adapted smartphone that achieves endoscopic-grade imaging of the ear drum whilst also being able to facilitate procedures such as microsuctioning via a specially designed mount. Using this device, it was possible to clean the patient’s ear from his hospital bed safely and with clear views. Both he and his wife were extremely impressed with the technology and were grateful that the procedure could be conducted outside the clinic.

Such devices have the potential to deliver much needed care to patients who have difficulty attending hospital appointments, such as those in nursing homes or with mobility issues. Furthermore, in the era of COVID-19, the ability to reduce footfall into the hospital and deliver care safely to the patient within the community is paramount. The otology team at the Royal National ENT hospital are now using this piece of technology to form the basis of a new, first-of-itskind ‘tele-otology service’. This will feature clinician remote review of patient history, video-otoscopic examination, audiometry & tympanometry all conducted off site enabling effective virtual consultation and shortening of patient pathways.

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