Telecommunication by means of multimedia technologies in oto-rhino-laryngology. ISDN - Internet - ATM

Telemedicine includes all medical activities in diagnosis, therapeutics, or social medicine undertaken by means of an electronic transfer medium, enab ling the transmission of visual and acoustic information over long distance s to doctors not personally present at the place of the requested consultat ion. Most experience with telemedicine applications has been gained in the field of diagnosis (teleconsultation, teleradiology, telepathology) and is expan ding to quality control and quality assurance. Decisive for each farm of ap plication is its availability, practicability, cost safety, and especially quality of audiovisual transmission. For telesurgical applications, particularly the use of minimally invasive t echniques in otorhinolaryngology, head, and neck surgery, the high quality transmission of audiovisual data in real time is necessary. Rapid expansion and further developments in transmission technologies and networks in the last decade have created several technologies with increased quality and co sts. In this paper, we tested different transmission media far audiovisual telec ommunication - integrated services digital network (ISDN), Internet, and as ynchronous transfer mode (ATM) - using real time video transmission of typi cal operations in otorhinolaryngology. Their applications, costs, and futur e perspectives are discussed.