Digital Frontiers in Ear, Nose & Throat Care: Telemedicine in Otorhinolaryngology across Sub-Saharan Africa: A Comprehensive Systematic Review and Narrative Synthesis

Abstract

Background: Sub-Saharan Africa bears a disproportionate burden of otorhinolaryngological (ENT) disease amid severe specialist workforce shortages, with fewer than one ENT surgeon per million population in many nations. Telemedicine offers a transformative pathway to bridge this gap and democratize access to specialist care.

Objective: To critically evaluate and synthesize evidence on the applications, clinical effectiveness, implementation barriers, and future prospects of telemedicine in ENT practice across Sub-Saharan Africa.

Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for studies published between January 2010 and February 2025. Following PRISMA 2020 guidelines, 52 eligible studies were identified from an initial pool of 612 records. Study designs included randomized controlled trials, cohort studies,cross-sectional surveys, and pilot studies. Methodological heterogeneity across included studies precluded meta-analysis; a structured narrative synthesis was employed.

Results: Tele-ENT interventions — encompassing teleconsultation, tele-audiology, mobile health platforms, and remote endoscopic assessment — demonstrated significant improvements in specialist access, reduction of travel burden by up to 60%, and enhanced rates of early diagnosis across otology, rhinology, laryngology, and head and neck oncology subspecialties. Nigeria, South Africa, Kenya, Ghana, and Ethiopia contributed the highest volume of evidence.

Conclusions: Telemedicine represents a scalable, cost-effective, and clinically viable solution for strengthening ENT healthcare delivery in Sub-Saharan Africa. Strategic investment in digital infrastructure, regulatory frameworks, and capacity building is imperative to sustain and expand tele-ENT services.