Evaluating the Use of Telemedicine in the Diagnosis and Treatment of Ear Infections: A Systematic Review
DOI:
https://doi.org/10.69980/ajpr.v28i5.519Keywords:
Telemedicine; Otitis Media; Ear Infections; ENT; Video Otoscopy; Telehealth; Remote Diagnosis; AI in Healthcare; Middle Ear Disease; eHealthAbstract
Background: Otitis media is a major global health concern, particularly among children, with significant implications for hearing loss and development. Access to timely and accurate diagnosis remains a challenge in low-resource and rural settings. Telemedicine has emerged as a potential solution, offering digital diagnostic and care delivery pathways for ear infections.
Objectives: To systematically evaluate the evidence on the effectiveness, diagnostic accuracy, and implementation of telemedicine in diagnosing and managing ear infections, including acute otitis media (AOM), otitis media with effusion (OME), and chronic suppurative otitis media (CSOM).
Methods: A systematic review was conducted according to PRISMA 2020 guidelines. Searches were performed across PubMed, Web of Science, Scopus, Embase, and Google Scholar for studies published between 2005 and 2025. Inclusion criteria encompassed peer-reviewed articles evaluating telemedicine interventions (e.g., video otoscopy, AI tools, remote consultation) for ear infections. Data were synthesized narratively due to heterogeneity in methods and outcomes.
Results: Fifteen studies were included: 6 diagnostic validation studies, 2 RCTs, 3 systematic reviews/meta-analyses, and others. Telemedicine interventions demonstrated high diagnostic accuracy (sensitivity up to 97%), reduced follow-up delays, and comparable outcomes to in-person care. Community-based and AI-assisted programs were particularly effective in pediatric and underserved populations. Cost savings and improved access were reported in multiple studies.
Conclusion: Telemedicine is a reliable and scalable approach for diagnosing and managing ear infections. When supported by appropriate infrastructure and training, it offers significant benefits in equity, efficiency, and clinical care, especially in remote and low-resource environments.
References
1. Altamimi, A. A. H., Brennan-Jones, C. G., & Hyde, M. (2024). A hospital-based asynchronous ENT telehealth service for children with otitis media: Cost-minimisation and improved access. Journal of Telemedicine and Telecare. https://doi.org/10.1177/1357633X231223994
2. Appelberg, E., Viitasalo, S., Hafrén, L., et al. (2024). Digital otoscopy in remote consultations. Laryngoscope Investigative Otolaryngology. https://doi.org/10.1002/lio2.70003
3. Brennan-Jones, C. G., et al. (2024). Ear Portal: An urban-based ENT and audiology referral telehealth portal to improve access. Journal of Telemedicine and Telecare, 30(2), 120–127. https://doi.org/10.1177/1357633X231158839
4. Camalan, S., Langefeld, C. D., Zinnia, A., et al. (2025). Impact of composite digital otoscopy on diagnosis. Otolaryngology–Head and Neck Surgery. https://doi.org/10.1002/ohn.965
5. Chen Wei. (2024). Revolutionizing Otolaryngology: The Impact of Telemedicine on Ear, Nose, and Throat Care. Journal of Otolaryngology Research, 14(6), 420. https://doi.org/10.35841/jorl-14.6.420
6. Coker, T. R., Chan, L. S., Newberry, S. J., Limbos, M. A., & Shekelle, P. G. (2010). Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children: A systematic review. JAMA, 304(19), 2161–2169. https://doi.org/10.1001/jama.2010.1651
7. Dai, Z., Wang, Y., Hang, C., Zhu, K., & Meng, X. (2021). Telemedicine for ear diseases with the smartphone otoscopes via WeChat in the COVID-19 era. International Journal of Pediatric Otorhinolaryngology, 146, 110752. https://doi.org/10.1016/j.ijporl.2021.110752
8. Dash, S., et al. (2024). Telemedicine-enabled otoscopes as catalysts for accessible and preventive ear health care: A systematic review and meta-analysis. Indian Journal of Community Medicine, 49(6), 796–804.
9. Eikelboom, R. H., et al. (2005). Validation of tele-otology to diagnose ear disease in children. International Journal of Pediatric Otorhinolaryngology, 69(6), 739–744. https://doi.org/10.1016/j.ijporl.2004.12.008
10. Garritano, F. G., & Goldenberg, D. (2011). Successful telemedicine programs in otolaryngology. Otolaryngologic Clinics of North America, 44(6), 1259–1274. https://doi.org/10.1016/j.otc.2011.08.003
11. Gupta, T., Gkiousias, V., & Bhutta, M. F. (2021). A systematic review of outcomes of remote consultation in ENT. Clinical Otolaryngology, 46(6), 1226–1235. https://doi.org/10.1111/coa.13768
12. Huang, W., et al. (2025). Effect of telehealth follow-up consultation in pediatric acute otitis media. Bulletin of the World Health Organization.
13. Khan, M. I., & Naim, A. (2024). Financial health management of otolaryngology by telemedicine: Opportunities and challenges. Asia Pacific Journal of Health Management. https://search.informit.org/doi/abs/10.3316/informit.T2025012400015390449152321
14. Marom, T., Pitaro, J., Shah, U. K., Torretta, S., et al. (2022). Otitis media practice during the COVID-19 pandemic. Frontiers in Cellular and Infection Microbiology, 11, 749911. https://doi.org/10.3389/fcimb.2021.749911
15. McConnochie, K. M., Conners, G. P., Brayer, A. F., & Goepp, J. G. (2006). Differences in diagnosis and treatment using telemedicine versus in-person evaluation of acute illness. Ambulatory Pediatrics, 6(4), 187–195. https://doi.org/10.1016/j.ambp.2006.04.002
16. Moentmann, M. R., Miller, R. J., & Yoo, G. H. (2020). Using telemedicine to facilitate social distancing in otolaryngology: A systematic review. Journal of Telemedicine and Telecare, 29(5). https://doi.org/10.1177/1357633X20985391
17. Nayak, G., et al. (2024). Evaluating video otoscopy for ENT diagnosis in resource-limited clinics. The Lancet Digital Health, 6(3). https://doi.org/10.1016/S2589-7500(24)00086-2
18. Pourshahrokhi, N., & Bahaadinbeigy, K. (2024). Diagnostic concordance of tele-otology app. SN Comprehensive Clinical Medicine, https://doi.org/10.1007/s42399-024-01666-6
19. Ramkumar, V., Suresh, K., & Krishnan, L. A. (2018). Identification and management of middle ear disorders in a rural cleft care program: A telemedicine approach. Journal of Audiology & Otology, 22(4), 201–207.
20. Robler, S. K., et al. (2023). Telemedicine referral to improve access to specialty care for preschool children in rural Alaska: A cluster-randomized controlled trial. Journal of Telemedicine and Telecare. https://doi.org/10.1177/1357633X231021013
21. Stephens, J. H., et al. (2025). Machine learning for otitis diagnosis in Aboriginal communities. Journal of Biomedical Informatics, 139, 104502. https://doi.org/10.1016/j.jbi.2025.104502
22. Suzuki, H., Marra, A. R., Hasegawa, S., et al. (2021). Outpatient antibiotic prescribing for common infections via telemedicine vs face-to-face visits: A systematic review and meta-analysis. Antimicrobial Stewardship & Healthcare Epidemiology, 1(1), e52. https://doi.org/10.1017/ash.2021.52
23. Zambelli-Weiner, A., Nathanson, B. H., Calcagno, F., Ansley, J., Vattana, K., & Burnette-Vick, B. (2025). Clinical utility of an optical coherence tomography middle ear scope: Interim results of the modification of antibiotic treatment intervention in children (OTO-MATIC) pragmatic cluster randomized controlled trial (RCT). International Journal of Pediatric Otorhinolaryngology, 193, 112356. https://doi.org/10.1016/j.ijporl.2025.111453
Downloads
Published
Issue
Section
License
Copyright (c) 2025 American Journal of Psychiatric Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License permitting all use, distribution, and reproduction in any medium, provided the work is properly cited.
