title: The Role of Telemedicine in Auditory Rehabilitation: A Systematic Review.
abstract: The purpose of this study was to assess the feasibility and effectiveness of live telemedicine applications in hearing amplification and cochlear implantation.
  
  
  
  A systematic search was performed in PubMed, MEDLINE, PsychINFO, CINALH, and Web of Science to identify peer-reviewed research. Inclusion criteria were titles containing words from the search terms 1) audiology, otolaryngology, and hearing impairment, 2) rehabilitative methods, and 3) telemedicine. Exclusion criteria were: 1) non-English articles, and 2) non-original research.
  
  
  
  Twelve eligible studies were identified. The studies employed a prospective design in nine of the articles and retrospective case series in three. The use of telemedicine for the provision of cochlear implant services was examined in eight of the articles and with hearing aids in four of the articles. The types of services include intraoperative cochlear implant telemetry; implant programming and assessment of electrode-specific measures and speech recognition after implantation. Hearing aid programming and remote gain assessments were also reported. Many studies assess patient and provider satisfaction along with encounter time comparison. The studies occurred from 2009 to 2014 and took place in seven countries.
  
  
  
  This review examined the feasibility of remote telemedicine connection to provide in auditory rehabilitation services through hearing aids and cochlear implants. There are significant concerns regarding Internet bandwidth limitations for remote clinics. There is a paucity of research examining reimbursement and cost-effectiveness for services. Further prospective research investigating cost-effectiveness and bandwidth limitations is warranted to assess long-term sustainability of remote audiological rehabilitative service delivery.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center, Lexington, Kentucky†Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Nairobi College of Medicine, Nairobi, Kenya.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bush
authors.forename: Robin
authors.initials: R
authors.lastname: Thompson
authors.forename: Catherine
authors.initials: C
authors.lastname: Irungu
authors.forename: John
authors.initials: J
authors.lastname: Ayugi
mesh_terms: D001298:Audiology; D019929:Cochlear Implantation / Q000534:rehabilitation*; D003054:Cochlear Implants; D003362:Cost-Benefit Analysis; D034381:Hearing Loss / Q000534:rehabilitation*; D006801:Humans; D020407:Internet; D012189:Retrospective Studies; D017216:Telemedicine