The Integration of Tele-Otolaryngology in Primary Care Settings: A Systematic Scoping Review of Diagnostic Accuracy and Referral Efficiency

The global burden of Otolaryngological (ENT) diseases is substantial, yet access to specialist care remains a bottleneck in many healthcare systems, leading to prolonged wait times and delayed diagnoses. Primary Care Physicians (PCPs) are typically the first point of contact for conditions ranging from otitis media to thyroid nodules. However, limited specialized equipment and ENT-specific training in family medicine often result in high rates of unnecessary referrals to tertiary hospitals. Tele-Otolaryngology (Tele-ENT) has emerged as a transformative solution, utilizing digital otoscopes, smartphone-integrated imaging, and asynchronous "store-and-forward" platforms to bridge this gap. By enabling remote specialist consultation or enhancing the diagnostic accuracy of PCPs through digital tools, Tele-ENT has the potential to streamline patient triaging, reduce travel burdens, and lower healthcare costs. Understanding the current efficacy and diagnostic reliability of these technologies within the primary care setting is essential for their integration into routine clinical practice. This review seeks to map the evidence regarding the implementation of Tele-ENT tools and their impact on clinical decision-making at the frontline of medicine.