Guidelines for otology surgery in coronavirus-19 pandemic

Meenesh Juvekar; Baisali Sarkar

doi:10.18203/issn.2454-5929.ijohns20203589

Authors

Meenesh Juvekar Department of Otorhinolaryngology, Grant Medical College and J.J Group of Hospitals and Bombay Hospital and Research Centre, Mumbai, Maharashtra
Baisali Sarkar Department of Otorhinolaryngology, Guwahati Neurological Research Centre, Kolkata, West Bengal

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20203589

Keywords:

SARS-CoV 2, Covid-19, Pandemic, Otology surgery

Abstract

Measures to be taken by the clinicians involved in Otology surgery in light of the recent COVID-19 pandemic. Current finding about COVID-19 infection and its relation with SARS-CoV 2 virus is evaluated and possible safety measure guidelines to be taken while doing Otological procedures is reviewed. Wearing PPE kit (N95 mask, double gloves, respirator, eye protection, face shield, gown, shoe cover ), limited attendance to essential personnel, using negative pressure room, using double drape system and proper removal of patient drape after rhinology operation reduces the risk of SARS-CoV 2 virus spread via aerosol into the environment. Emergent and Urgent otology surgery need prompt treatment, thus proper COVID-19 protocols should be maintained while doing otology surgery like wearing PPE ( N95 mask, double gloves, respirator, eye protection, face shield, gown, shoe cover ), limit attendance to essential personnel and use negative pressure room are undertaken. Double draping of the operating site is essential while drilling and suctioning and it’s too carried out under the plastic tent to reduce aerosol spread in the environment. Proper removing of the tent setup, including rolling of patient drape is needed to reduce aerosol spread. Otology surgeries should adhere to general guidelines set for high-risk procedures.

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Author Biography

Meenesh Juvekar, Department of Otorhinolaryngology, Grant Medical College and J.J Group of Hospitals and Bombay Hospital and Research Centre, Mumbai, Maharashtra

Professor and Unit Head G T Hospital, Mumbai

Surgeon, Bombay Hospital, Mumbai

References

Coronavirus disease 2019 (COVID-19) Symptoms and causes; Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963. Accessed on 14 April 2020.

Hui DS, I Azhar E, Madani TA, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264-266.

WHO Director-General'sopening remarks at the media briefing on COVID 19. World Health Organization (WHO) (Press release). 11 March 2020. Archived from the original on 11 March 2020. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-11-march-2020. Accessed on 12 March 2020.

How COVID-19 Spreads. Centers for Disease Control and Prevention (CDC). 2 April 2020. Archived from the original on 3 April 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html. Accessed on 3 April 2020.

Q & A on COVID-19. European Centre for Disease Prevention and Control. Available at: https://www.ecdc.europa.eu/en/covid-19/questions-answers. Accessed on 30 April 2020.

DGHNO-KHC, BVHNO. Aktuelle Informationen zum Thema Pragmatischer Personalschutz durch Schutzmasken/ Visiere außerhalb von krankenhausspezifischen. Covid-19-Isolationsund OP-Bereichen von Seiten der DGHNO-KHC und des BVHNO. Available at: https://www.ncbi.nlm.nih.gov/pubmed/?term=Anagiotos%20A%5BAuthor%5D&cauthor=true&cauthor_uid=32577905. Accessed on 31 May 2020.

van Doremalen N, Bushmaker T, Morris DH. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARSCoV-1. N Engl J Med. 2020;382:1564-7.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.

Symptoms of Coronavirus. U.S. Centers for Disease Control and Prevention (CDC). 13 May 2020. Archived from the original on 17 June 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html. Accessed on 18 June 2020.

Hessen MT. Novel Coronavirus Information Center: Expert guidance and commentary. Elsevier Connect. Available at: https://www.elsevier.com/connect/coronavirus-information-center. Accessed on January 2020.

Grant MC, Geoghegan LA, Marc MZ, McGuinness L, Clarke, Wade RG et al. The prevalence of symptoms in 24, 410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. PLOS ONE. 2020;15(6): e0234765.

Jackler R. COVID-19 and ear surgery. AAO-HNS. Available at: https://www.entnet.org/sites/default/ files/uploads/covid-19_and_ear_surgery_rk_ jackler_stanford.pdf. Accessed on 2 May 2020.

Kozin ED, Blevins NH, Jan TA. American neurotology society position statement on management of otologic and neurotologic patients during the COVID-19 pandemic. Otol Neurotol; 2020. Available at: https://escholarship.umassmed.edu/covid19/51.

Carron JD, Buck LS, Harbarger CF, Eby TF. A simple technique for droplet control during mastoid surgery. JAMA Otolaryngol Head Neck Surg. 2020; e201064.

Chen JX, Workman AD, Chari DA. Demonstration and mitigation of aerosol and particle dispersion during mastoidectomy relevant to the COVID-19 era. Otol Neurotol; 2020.

Guidance for ENT surgeons during the COVID-19 pandemic. ASOHNS. Available at: https://www.ahns.info/wp-content/uploads/2020/03/Australian-Guidance-for-ENT-surgeons-during-the-COVID.pdf. Accessed on 2 May 2020.

Considerations on H&N during COVID-19. Irish Head and Neck Society. Available at: https://www.ahns.info/wp-content/uploads/2020/03/ Irish-Head-and-Neck-Society-considerations-on-COVID-20-3-20.pdf, Accessed on 10 April 2020.

COVID-19: considerations for optimum surgeon protection before, during, and after operation. American College of Surgeons. Available at: https://www.facs.org/covid-19/clinical-guidance/ surgeon-protection, Accessed 10 April 2020.

D. Lu, H. Wang, R. Yu, H. Yang, Y. Zhao. Integrated infection control strategy to minimize nosocomial infection of coronavirus disease 2019 among ENT healthcare workers. J Hosp Infect. 2020;104:454-5.

J. Irish. Synopsis of the Toronto Approach. AHNS. Available at: https://www.ahns.info/wp-content/ uploads/2020/03/Jonathan-Irish-Synopsis-of-the-Toronto-Approach.pdf. Accessed 10 April 2020.

Appendix B. Air guidelines for environmental infection control in health-care facilities (2003). U.S. HHS. Available at: https://www.cdc.gov/ infectioncontrol/guidelines/environmental/appendix/air.html, Accessed 20 April 2020.

HeikkinenT, Thint M, Chonmaitree T. Prevalence of various respiratory viruses in the middle ear during acute otitis media. N Engl J Med. 1999;340:260-264.

Givi B, Schiff BA, Chinn SB. Safety recommendations for evaluation and surgery of the head and neck during the COVID-19 pandemic. JAMA Otolaryngol Head Neck Surg. 2020

Hellier W, Mitchell T, Thomas S. Mastoidectomy in the COVID era– the 2-microscope drape method to reduce aerosolization. Br Soc Otology. Accessed 12th Apr 2020. Published 2020. Available at: https://www.entuk.org/sites/default/files/Mastoidectomy%20in%20the%20COVID%20Era%20%E2%80%93%20The%202.pdf. Accessed on 15 April 2020.

He F, Deng Y, Li W. Coronavirus disease 2019: What we know? J Med Virol. 2020;92(7):719-25.