Effectiveness of telemedicine consultations in the diagnosis and management of patients with vestibular disorders

OBJECTIVE: To evaluate the clinical effectiveness and practical feasibility of telemedicine technologies in the management of patients with vestibular disorders. MATERIAL AND METHODS: The study included 174 patients presenting with complaints of dizziness. During the remote consultation stage, a diagnostic concept was formulated based on patient complaints, medical history, and previously performed examinations. Subsequently, 166 patients underwent in-person evaluation to verify the clinical diagnosis and assess concordance with the preliminary hypothesis. Over a 6-month period, remote follow-up was conducted, analyzing repeated teleconsultations and the need for in-person visits. RESULTS: Complete or partial concordance between the remote diagnostic concept and the final clinical diagnosis was observed in 97.5% of cases, with complete concordance in 65.0%; complete discrepancy was identified in 2.5% of patients. In 29.5% of patients, a combination of multiple otoneurological diagnoses was established, and in 10.4% of cases a differential diagnostic spectrum of nosologies remained. During the 6-month follow-up, 73.6% patients actively used teleconsultations, and 20.0% patients required repeated in-person examinations. In acute vestibular syndromes, in-person visits were significantly more frequent, whereas in episodic and chronic forms, remote monitoring predominated. In the episodic vestibular syndrome group, patients with benign paroxysmal positional vertigo had significantly more repeat in-person examinations than patients with Ménière's disease and vestibular migraine. After 6 months, positive clinical dynamics were observed in the majority of patients, including those who received interdisciplinary consultations with related specialists. CONCLUSION: The use of telemedicine technologies in the management of patients with vestibular disorders ensures a high level of diagnostic consistency, enables efficient allocation of in-person consultations based on the clinical situation, thereby reducing the burden on specialized care, and maintains continuity of care. A promising direction for further research is the development of standardized telemedicine algorithms for diagnosis, monitoring, and multidisciplinary interaction, taking into account the high prevalence of combined forms of vestibular pathology.