Conclusion
Telephone clinics have an important role to play in the review and assessment of new otology referrals and have been a useful tool in our response to the COVID19 pandemic. However, they are limited by a lack of clinical examination and audiometric assessment. As a result, the follow-up rate is significantly higher, with fewer patients either discharged or added to a waiting list for treatment, when compared to patients seen directly in a face-to-face clinic. Furthermore, patients require more appointments, on average, to reach a definitive management outcome. Further research is required on the role of a telemedicine pathway in otology which utilises endoscopic examination of the ear alongside audiometry, followed by asynchronous assessment by a consultant otologist. This may maximise the benefits of telemedicine whilst ensuring that a high proportion of patients receive a definitive management decision at their initial appointment, whilst reducing unnecessary follow-up.