The COVID-19 pandemic and challenges in offering health services at the time showed how useful telehealth services can be. One of the undoubted benefits of video otoscopy is that both images and recordings can be sent to specialists for assessments. The study aimed to investigate how reliable the diagnosis of middle ear disease may be by using the asynchronous assessment of video otoscopic images and recordings. In total, 146 children were tested using video otoscopy and tympanometry. Additionally, a brief case history was taken from the children’s parents. HearScope equipment was used for video otoscopy, and Titan for tympanometry. The first stage of the study was to diagnose all cases by an audiologist and a consultant ENT surgeon four to six months after all tests were performed, in regards to ability to make an accurate diagnosis and then label results as normal and abnormal, with referral and without referral for further treatment. The second step of the study took place at least eight months after the first diagnosis and aimed at rediagnosing 47 cases, of which half were normal results and half abnormal. The results were analysed by using Cohen’s Kappa statistics to compare reliability between audiologist diagnosis for both stages, ENT surgeon diagnosis for both stages and between audiologist and ENT surgeon diagnosis for both stages of the study where agreement found was almost perfect, moderate and moderate to substantial respectively. The authors concluded that audiologists could be used to assess the middle ear problems and to triage children to ENT services, which could help in reducing waiting time. It would be interesting to see whether a different choice of video otoscopy equipment may impact the results. Additionally, as authors rightly indicated, it would be good to investigate more ENT and audiologist diagnosticians as this would allow for a comparison of diagnoses within a specific group of professionals.