Telemedicine-Enhanced Neurotology Skull Base Program in Post-Katrina Louisiana

Introduction: A combined real-time and store-and-forward telemedicine service has permitted development of an active Neurotologic Skull Base Program despite only part-time availability of all team members in the same location. Method: Retrospective chart review study. Results: Since 2006, 54 neurotologic skull base tumor patients have been treated with this delivery model with limited on-site neurotology and full-time neurosurgery and head and neck surgery availability. Telemedicine has permitted videoconferencing, remote image review, videoendoscopy, and video-infrared nystagmography, which permit complete off-site capabilities for neurotologic consultation. Clinical outcomes for this delivery model in terms of morbidity, patient satisfaction, and timeliness of management are equivalent to published outcomes and the authors own outcomes in a standard delivery system. Conclusion: Telemedicine is a viable mode for effective neurotologic consultation for skull base tumor management. This presentation will review the special technical, administrative, insurance, and medicolegal requirements of this delivery model.