Guidelines for the endoscopic nasal surgery during COVID-19 pandemic

Authors

  • Parvez Husain Department of ENT, Expert ENT and Diagnostic Centre, Barabanki, Uttar Pradesh, India http://orcid.org/0000-0001-8118-1365
  • Shaheen Khalil Ahmed Department of Anaesthesia, Expert ENT and Diagnostic Centre, Barabanki, Uttar Pradesh, India
  • Benazeer Husain Department of Oral Pathology, Expert ENT and Diagnostic Centre, Barabanki, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20205086

Keywords:

COVID-19, Endoscopic, Nasal surgery, Pandemic

Abstract

COVID-19, the respiratory illness caused by the novel SARS-CoV-2 virus has rapidly emerged as a serious global health concern. The world health organization (WHO) and has enacted various protocols for healthcare institutions internationally in an attempt to slow the spread of disease, including adjustments for procedures performed by otolaryngologists. Based upon published evidence we highlight different strategies to reduce infection transmission during endoscopic sinus surgery. All patients undergoing endoscopic sinus surgery should be discussed with health care staff to be involved in procedure. The patients should be divided into elective, semi-elective, and urgent/emergency. COVID-19 test should be done in all patients prior to surgery along with high resolution computed tomography (HRCT) chest. Irrespective of COVID screening results, it is advisable to treat all patients undergoing aerosol generating procedures as COVID-19 positive, and the whole theatre team should wear personal protection equipment (PPE) as per current national guidelines. Preoperative nasal decongestion to be undertaken with atomization devices. Consider telephone/video clinic follow up appointments unless clinical examination is considered essential. Considering the current health crisis caused by COVID-19, the following guidelines are recommended for performing nasal surgeries: patient visits must be limited to only urgent/emergent cases for the time being. Only vital personnel should remain in the OT while performing any nasal endoscopic procedure as this will both reduce exposure and conserve vital personal protective equipment. Five levels of protection are recommended for the person performing the procedure.

Author Biographies

Parvez Husain, Department of ENT, Expert ENT and Diagnostic Centre, Barabanki, Uttar Pradesh, India

Department Of ENT, Consultant.

Shaheen Khalil Ahmed, Department of Anaesthesia, Expert ENT and Diagnostic Centre, Barabanki, Uttar Pradesh, India

Department of Anaesthesia. Senior Resident.

Benazeer Husain, Department of Oral Pathology, Expert ENT and Diagnostic Centre, Barabanki, Uttar Pradesh, India

Department of Oral Pathology, Consultant.

References

WHO. WHO Director-General's Opening Remarks at the Media Briefing on COVID-19. 2020. Available at: www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. Accessed on 02 August 2020.

Hui DS, Azhar IE, Madani TA, Ntoumi F, Kock R, Dar O. 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;91:264-6.

WHO. 2020. Operational Planning Guidelines to Support Country Preparedness and Response. Available at: www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/training-courses. Accessed on 02 August 2020.

Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Eng J Med. 2020;382(12):1177-9.

Advice on the use of masks in the context of COVID-19. Interim guidance. Geneva: World Health Organization. 2020. Available at: https://www.who. int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak). Accessed on 02 August 2020.

Van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382:1564-7.

Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): emerging and future challenges for dental and oral medicine. J Dent Res. 2020;99(5):481-7.

Lai THT, Tang EWH, Chau SKY, Fung KSC, Li KKW. Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong. Graefes Arch Clin Exp Ophthalmol. 2020;3:1-7.

Lu D, Wang H, Yu R, Yang H, Zhao Y. Integrated infection control strategy to minimize nosocomial infection of coronavirus disease 2019 among ENT healthcare workers. J Hosp Infect. 2020;104(4):454-5.

Specialty guide Essential Cancer surgery and coronavirus. Available at: https://www.england. nhs.uk/coronavirus/wp-content/uploads/sites/52/2020 /04/C0239-Specialty-guide-Essential-Cancer-surgery -and-coronavirus-v1-70420.pdf 5. Accessed on 02 August 2020.

Wuhan novel corona virus infection prevention and control. Available at: https://www.gov.uk/ government/publications/wuhan-novel-coronavirus-infectionprevention-and-control. Accessed on 02 August 2020.

Geller C, Varbanov M, Duval RE. Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses. 2012;4:3044e68.

Eggers M, Koburger-Janssen T, Eickmann M, Zorn J. In Vitro Bactericidal and Virucidal Efficacy of Povidone-Iodine Gargle/Mouthwash Against Respiratory and Oral Tract Pathogens. Infect Dis Ther. 2018;7(2):249-59.

Kanagalingam J, Chopra A, Hong M, Ibrahim W, Villalon A, Lin J. Povidone-iodine for the management of oral mucositis during cancer therapy. Oncol Reviews. 2017;11(2).

Panchmatia R, Payandeh J, Al-Salman R, Kakande E, Habib A, Mullings W et al. The efficacy of diluted topical povidone-iodine rinses in the management of recalcitrant chronic rhinosinusitis: a prospective cohort study. Eur Arch Oto-Rhino-Laryngol. 2019;276(12):3373-81.

Rezapoor M, Nicholson T, Tabatabaee R, Chen A, Maltenfort M, Parvizi J. PovidoneIodine–Based Solutions for Decolonization of Nasal Staphylococcus aureus: A Randomized, Prospective, Placebo-Controlled Study. J Arthroplasty. 2017;32(9):2815-9.

Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hospital Infect. 2020;104(3):246-51.

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

Kariwa H, Fujii N, Takashima I. Inactivation of SARS coronavirus by means of povidone-iodine, physical conditions and chemical reagents. Dermatol (Basel). 2006;212(1):119-23.

British Standard Institution. Specification for The Planning, Application, Measurement and Review of Cleanliness Services In Hospitals. London: BSI. 2014.

Rajan N, Joshi GP. The COVID-19: Role of Ambulatory Surgery Facilities in This Global Pandemic. Anesth Analg. 2020;131(1):31-6.

Alvi S, Harsha P. Flexible Nasopharyngoscopy. StatPearls Publishing. 2020.

Services Cf MM CMS Adult Elective Surgery and Procedures Recommendations. 2020. Available at: http://cqcounter.com/whois/domain/cfmm.com.html. Accessed on 02 August 2020.

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Published

2020-11-24

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Section

Review Articles