American Neurotology Society, American Otological Society, and American Academy of Otolaryngology – Head and Neck Foundation Guide to Enhance Otologic and Neurotologic Care During the COVID-19 Pandemic

Kozin, Elliott D.; Remenschneider, Aaron K.; Blevins, Nikolas H.; Jan, Taha A.; Quesnel, Alicia M.; Chari, Divya A; Kesser, Bradley W.; Weinstein, Jaqueline E; Ahsan, Syed F.; Telischi, Fred F.; Adunka, Oliver F.; Weber, Peter; Knoll, Renata M.; Coelho, Daniel H.; Anne, Samantha; Franck, Kevin H.; Marchioni, Daniele; Barker, Frederick G.; Carter, Bob S.; Lustig, Lawrence R.; Bojrab, Dennis I.; Bhansali, Sanjay A.; Westerberg, Brian D.; Lundy, Larry; Jackler, Robert K.; Roland, Jeremy; Chandrasekhar, Sujana S.; Antonelli, Patrick J.; Carey, John P.; Welling, D. Bradley; Slattery, William H.; Lee, Daniel J

doi:10.1097/mao.0000000000002868

Cited by 17 publications

(31 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Otologic surgery, including drilling of the mastoid, is known to cause a substantial dispersion of small and large aerosols (Anschuetz et al, 2021;Chari et al, 2021;Hajiyev and Vilela, 2021;Merven and Loock, 2021;Sharma et al, 2021) and droplets (Sharma et al, 2020;Mohan et al, 2021;Sharma et al, 2021), and is a cause of concern regarding contamination in the operating room (OR). To prevent unnecessary risk of infection, otologic procedures were categorized as urgent versus elective, according to different authors and otolaryngological societies (Kozin et al, 2020;Leboulanger et al, 2020;Pattisapu et al, 2020;Saadi et al, 2020), suggesting that urgent operations should be performed, while all other operations should be postponed, depending on the pathology and the patient's preference.…”

Section: Changes In Conceptmentioning

confidence: 99%

“…PPE can be divided into two categories: 1) respiratory protection (N95 respirator, powered air-purifying respirator [PAPR]), and 2) body protection, including eye protection, sterile and waterproof clothes around the neck, and disposable cap, gown, overshoes, and gloves. PPE is advised for any surgery performed, and especially for procedures with a high aerosol dispersion potential, such as mastoidectomy (Ayache and Schmerber, 2020;Gordon et al, 2020;Kozin et al, 2020;Leboulanger et al, 2020;Sharma et al, 2021).…”

Section: Personal Protective Equipmentmentioning

confidence: 99%

See 1 more Smart Citation

Otitis Media Practice During the COVID-19 Pandemic

Marom¹,

Pitaro

Shah

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

The global coronavirus disease-2019 (COVID-19) pandemic has changed the prevalence and management of many pediatric infectious diseases, including acute otitis media (AOM). Coronaviruses are a group of RNA viruses that cause respiratory tract infections in humans. Before the COVID-19 pandemic, coronavirus serotypes OC43, 229E, HKU1, and NL63 were infrequently detected in middle ear fluid (MEF) specimens and nasopharyngeal aspirates in children with AOM during the 1990s and 2000s and were associated with a mild course of the disease. At times when CoV was detected in OM cases, the overall viral load was relatively low. The new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen responsible for the eruption of the COVID-19 global pandemic. Following the pandemic declaration in many countries and by the World Health Organization in March 2020, preventive proactive measures were imposed to limit COVID-19. These included social distancing; lockdowns; closure of workplaces; kindergartens and schools; increased hygiene; use of antiseptics and alcohol-based gels; frequent temperature measurements and wearing masks. These measures were not the only ones taken, as hospitals and clinics tried to minimize treating non-urgent medical referrals such as OM, and elective surgical procedures were canceled, such as ventilating tube insertion (VTI). These changes and regulations altered the way OM is practiced during the COVID-19 pandemic. Advents in technology allowed a vast use of telemedicine technologies for OM, however, the accuracy of AOM diagnosis in those encounters was in doubt, and antibiotic prescription rates were still reported to be high. There was an overall decrease in AOM episodes and admissions rates and with high spontaneous resolution rates of MEF in children, and a reduction in VTI surgeries. Despite an initial fear regarding viral shedding during myringotomy, the procedure was shown to be safe. Special draping techniques for otologic surgery were suggested. Other aspects of OM practice included the presentation of adult patients with AOM who tested positive for SARS-2-CoV and its detection in MEF samples in living patients and in the mucosa of the middle ear and mastoid in post-mortem specimens.

show abstract

Section: Changes In Conceptmentioning

confidence: 99%

Section: Personal Protective Equipmentmentioning

confidence: 99%

Otitis Media Practice During the COVID-19 Pandemic

Marom¹,

Pitaro

Shah

et al. 2022

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

show abstract

“…), which requires a high priority level within the hospital administration. Besides the ORL emergencies and cancer patients, the Head and Neck Department is also a referral center for other surgical procedures, such as cochlear implantation (CI), that necessitate time sensitive operative management [18]. Given these premises and the complexity of the organization, an integrated strategy was requested in order to provide adequate treatment to every patient within an appropriate timeframe.…”

Section: Introductionmentioning

confidence: 99%

Managing head and neck cancer patients during the COVID-19 pandemic: the experience of a tertiary referral center in southern Italy

Longo

Trecca

D’Ecclesia

et al. 2021

Infect Agents Cancer

View full text Add to dashboard Cite

Background The medical community has been deeply involved in fighting the Coronavirus disease 2019 (COVID-19) pandemic and, as a consequence, the care of non-COVID-19 patients has been impacted. However, the treatment of head and neck cancer patients is not deferrable, and an integrated strategy is required. The aim of the current article is to present the experience in the management of head and neck patients during the COVID-19 pandemic at the research hospital “Casa Sollievo della Sofferenza”. This review contains replicable and widely usable instructions on how to avoid delays in the diagnosis and treatment of head and neck tumors and to ensure a gradual return to elective procedures. Main text The Head and Neck Department of the research hospital “Casa Sollievo della Sofferenza” includes an Otolaryngology and a Maxillofacial Surgery Unit, both of which deal with the diagnosis and treatment of benign and malignant pathologies of the head and neck, as well as urgent/emergent consultations and surgical procedures that necessitate time sensitive operative management, such as cochlear implantation (CI). Given these premises and the complexity of the Department, the “COVID-19 organizing protocol” of the research hospital “Casa Sollievo della Sofferenza” was divided into two phases in accordance with the different stages of the pandemic and the priority of treatment. Special attention was given to the medical surveillance of health care workers and hospitalized patients, to the organization of the outpatient clinic and the operating setting as well as to the implementation of telehealth systems. Conclusions The COVID-19 pandemic is going to be a long-term situation with lasting effects on the public health and the entire society. Therefore, an efficient health care system has to adopt a double strategy: always being ready for a “new wave” of the pandemic and not forgetting non-COVID-19 patients, among whom head and neck cancer patients represent a priority. More than 1 year since the first outbreak in Wuhan, this review offers a unique and helpful perspective that incorporates awareness of the disease.

show abstract

“…First, those positive for SARS CoV-2, patients with diagnosed COVID-19 or under investigation with their PCR pending and emerging procedures with an unknown infection status. Second, an intermediate risk group consisting of patients who have been tested SARS CoV-2 negative and asymptomatic patients who have not yet been tested [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of aerosol production and aerosol dispersion during otologic surgery

Serrano

Santiago‐Sáez

Rodriguez

et al. 2021

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Background As a respiratory disease, the transmission of Coronavirus disease (COVID-19) is mainly caused by small droplets and aerosols. Healthcare personnel are particularly exposed during otologic surgery given the continuity with the nasopharynx, where the viral load is high, and the use of high-speed instruments. The purpose of the present study is to test a model of droplet dispersion produced in the performance of a drilling procedure on human bone to provide information about its distribution and size of the deposit in similar conditions to those of an operating theatre, to design different preventive measures. Material and method A mastoidectomy and trans -labyrinthine approach were performed on an embalmed human corpse using for irrigation during drilling methylene blue dye in physiological saline solution (pss) at a concentration of 0.324 mg/mL. The distribution of the drops was stablished using semi-absorbent papers of size 52 cm × 42 cm covering the area around the dissection field to a radius of 150 cm and on the corpse at different heights to check vertical dispersion. The collected deposit material was analysed with the microscope at different magnification objectives. Results Droplets between 2 μm and 2.6 cm were obtained. The visualization of the coloured droplets in the horizontal plane at a magnification of 1.5 was detected at 150 cm from the focus of emission of milling particles. Discussion According to our study, bone drilling with high speed motors under continuous saline irrigation in a haemorrhagic surgical field increases the amount of aerosols exposing healthcare personnel to additional airbone particles. This risk does not end in the operating rooms as particles smaller than 2 μm can be suspended in the air for hours and could exit the operating theatre due to the use of positive pressure systems. Thus, the use of N95, FFP2, FFP3 or PAPRS should be considered and the development of hood systems to prevent the dispersion of aerosols during these procedures should be considered.

show abstract

American Neurotology Society, American Otological Society, and American Academy of Otolaryngology – Head and Neck Foundation Guide to Enhance Otologic and Neurotologic Care During the COVID-19 Pandemic

Cited by 17 publications

References 64 publications

Otitis Media Practice During the COVID-19 Pandemic

Otitis Media Practice During the COVID-19 Pandemic

Managing head and neck cancer patients during the COVID-19 pandemic: the experience of a tertiary referral center in southern Italy

Analysis of aerosol production and aerosol dispersion during otologic surgery

Contact Info

Product

Resources

About