Are in-person postoperative parotidectomy follow-ups a thing of the past?

Antezana, L. A.; Xie, K. Z.; Yeakel, S. R.; Moore, E. J.

Introduction: COVID-19 accelerated the need for virtual visits within health care, and otolaryngology was no exception. We examined whether otolaryngologists are able to perform postoperative care through a virtual visit platform, specifically for patients who underwent parotidectomy. Method: A retrospective case review under institutional review board exemption of patients who underwent parotidectomy and postoperative video visits between September 2019 and December 2020 was conducted. A chart review of all video visits was sorted for “established” patients (ie, previously seen by the department presenting for surveillance, surgery follow-up, or new concern) and narrowed to postoperative parotidectomy follow-up patients. Days between surgery and postoperative follow-up, treatment plan, and postvisit outcomes were reviewed. Treatment plan was designated as follows: yes, a definitive treatment plan was made;no, a provider required additional in-person visits;and, not applicable, no concerns existed. Outcomes measures included whether an inperson follow-up was recommended and if a follow-up occurred. Results: There were 447 head and neck virtual visits found, 302 established visits, and 194 new video visits. There were 96 postoperative parotidectomy patients. Demographics were 28 male and 68 female, with an average age of 54 years. The first video visit occurred, on average, 48 days postop. Of the patients, 8.3% (n = 8) presented with minor complications (eg, eye dryness, seroma, first bite pain) and required a treatment plan. The virtual visit was sufficient for prescribing a plan for 100% of those visits. For the other 91.7% of patients (n = 88), no treatment plan was required, and 26% were instructed to follow up (n = 25), 23 of whom were routine for surveillance and 2 for procedural follow-up. All other patients were instructed to follow up as needed. We noted 11 clinic and 2 surgery (hematoma evacuation, seroma aspiration) follow-ups at the time of review. Conclusion: The results demonstrate the ability to make definitive decisions about a parotidectomy patient's postoperative care through a virtual visit platform. This study supports the feasibility of transitioning in-person parotidectomy postop visits to virtual.