Estrategias para la práctica de la otorrinolaringología y cirugía de cabeza y cuello durante la fase de control de la COVID-19

Maza‐Solano, Juan; Plaza-Mayor, Guillermo; Jiménez-Luna, Antonio; Parente‐Arias, Pablo; Amor-Dorado, Juan Carlos

doi:10.1016/j.otorri.2020.05.001

Cited by 8 publications

(5 citation statements)

References 41 publications

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“…Esta especialidad se encarga de una amplia variedad de afecciones, desde la otitis media y la sinusitis hasta el cáncer de cabeza y cuello. (18) Se realiza en un entorno quirúrgico, generalmente bajo anestesia general o local, dependiendo del procedimiento específico y las necesidades del paciente. Los cirujanos otorrinolaringólogos utilizan una variedad de técnicas quirúrgicas, que van desde cirugías de rutina hasta procedimientos altamente complejos.…”

Section: Cirugía Otorrinolaringológicaunclassified

“…La cirugía otorrinolaringológica es un conjunto de procedimientos quirúrgicos realizados en la cabeza y el cuello, incluyendo las vías respiratorias superiores, la cavidad oral y la faringe, la laringe, el oído y los senos paranasales. Principios generales de la cirugía: (18) Preparación del paciente: Antes de cualquier cirugía, es importante que el paciente esté en buenas condiciones de salud. Se realizan exámenes de laboratorio y pruebas de diagnóstico para determinar la extensión de la enfermedad y el riesgo quirúrgico.…”

Section: Principios Generales De La Cirugía Otorrinolaringológicaunclassified

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Explorando Los Sentidos: Un Viaje Por La Otorinolaringologia

ECHEVERRIA,

GUERRERO,

PARRA

et al. 2023

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La otorrinolaringología es una especialidad médica fascinante y desafiante, que se ocupa del diagnóstico y tratamiento de las patologías que afectan a las vías respiratorias superiores y a las estructuras de la cabeza y el cuello. Desde las enfermedades más comunes, como la sinusitis y la otitis media, hasta las patologías más complejas y de difícil manejo, como los tumores de cabeza y cuello, la otorrinolaringología abarca una amplia variedad de condiciones clínicas que tienen un impacto significativo en la calidad de vida de los pacientes. Este libro, escrito por expertos en la materia, ofrece una visión general de la otorrinolaringología, que abarca desde la anatomía y fisiología de las estructuras del oído, la nariz y la garganta, hasta los procedimientos quirúrgicos más avanzados para la reconstrucción de la laringe y la extirpación de tumores. Pero más allá de las técnicas y procedimientos, este libro también ofrece una perspectiva humanística sobre la atención médica en otorrinolaringología. El tratamiento de las patologías de la cabeza y el cuello no solo implica habilidades técnicas y conocimientos médicos, sino también una comprensión profunda de la experiencia de los pacientes y sus necesidades emocionales y psicológicas. Esperamos que este libro sea una valiosa fuente de información y orientación para los estudiantes de medicina, los residentes en otorrinolaringología y los profesionales de la salud que buscan mejorar su comprensión y habilidades en esta fascinante especialidad. Y sobre todo, esperamos que este libro ayude a mejorar la calidad de vida de los pacientes que confían en nosotros para cuidar de su salud auditiva, respiratoria y vocal.

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Section: Cirugía Otorrinolaringológicaunclassified

Section: Principios Generales De La Cirugía Otorrinolaringológicaunclassified

Explorando Los Sentidos: Un Viaje Por La Otorinolaringologia

ECHEVERRIA,

GUERRERO,

PARRA

et al. 2023

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“…In comparison, for FEES, an endoscope is introduced through the nostrils to the glottic area, and swallowing is observed directly as the patient consumed water with different volumes and textures 21 . Both explorations are relatively contraindicated in cases of SARS-CoV-2 infection since they generate aerosols, which favour contagion; thus, the published articles do not recommend their use, and such studies should be strictly limited to patients with a high risk of aspiration/malnutrition 22 .…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, a bedside screening test is recommended. For this, complete personal protective equipment (PPE) must be worn with an FFP3 mask, and it is recommended to keep 2 metres away from the patient at the time of swallowing and to stay to the patient's side to avoid the trajectory of the aerosols 22 . Two years before the pandemic, our centre validated the Modi ed Viscosity Volume Swallowing Test (mV-VST) 23 , a bedside screening method that facilitates the diagnosis of dysphagia and was performed during the rst wave of the pandemic prior to the start of the oral diet (Fig.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia and Mechanical Ventilation in Sars-Cov-2 Pneumonia: It’s Real

Laguna

Marcos-Neira

Zurbano

et al. 2021

Preprint

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BACKGROUND. Severe SARS-CoV-2 pneumonia has brought intensive care units (ICUs) and the consequences of prolonged hospitalisation, such as dysphagia, into focus.METHODS. Study population: Patients with severe pneumonia due to SARS-CoV-2 who required admission to critical units from March to June 2020. Dysphagia diagnostic method: Modified Viscosity Volume Swallowing Test (mV-VST). Objectives. To identify risk factors for dysphagia in patients with severe SARS-CoV-2 pneumonia requiring invasive mechanical ventilation and determine their incidence. Statistical analysis: Descriptive analysis of means or medians according to the normality of quantitative variables and proportions for the descriptive variables (95% CI). Univariate analysis of dysphagia using simple logistic regression. Multivariate analysis and construction of a predictive model for dysphagia using logistic regression.RESULTS. Descriptive analysis. Sample size: 232 patients; 72% (167) required intubation. Of these, 65.9% (110) survived and 84.5% (93) underwent the mV-VST, which diagnosed 26.9% (25) with dysphagia. Age: 60.5 years (95% CI: 58.5 to 61.9). Men: 74.1% (95% CI: 68.1 to 79.4). APACHE II score: 17.7 (95% CI: 13.3 to 23.2). Mechanical ventilation: 14 days (95% CI: 11 to 16); prone position: 79% (95% CI: 72.1 to 84.6); respiratory infection: 34.5% (95% CI: 28.6 to 40.9). Renal failure: 38.5% (95% CI: 30 to 50). Overall mortality: 25.9% (95% CI: 20.6 to 31.9). Mortality in intubated patients: 34.1% (95% CI: 27.3 to 41.7). No patient diagnosed with dysphagia died. Univariate analysis. APACHE II, prone position, days of mechanical ventilation and need for tracheostomy, respiratory infection, kidney failure developed during admission and length of ICU and hospital stay were significantly associated (p<0.05) with dysphagia. Multivariate analysis. Dysphagia is independently explained by APACHE II score (OR: 1.1; 95% CI: 1.01 to 1.3; p=0.04) and tracheostomy (OR: 10.2; 95% CI: 3.2 to 32.1; p<0.001). The resulting predictive model predicts dysphagia with a good ROC curve (AUC: 0.8; 95% CI: 0.7 to 0.9)CONCLUSIONS. Dysphagia affects almost one-third of patients, and the risk of developing dysphagia increases with prolonged mechanical ventilation, tracheostomy and greater severity on admission (APACHE II score).

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“…At the beginning of the pandemic, addressing the uncertainty on the transmission mechanisms of the virus and overcoming a shortage of personal protective equipment became the main priorities. Clinical pathways and hospital structures were redesigned to assist patients affected by COVID-19, to the detriment of the assistance given to non-COVID-19 patients [6]. Many hospitals and healthcare centers were forced to cancel non-urgent surgical interventions due to the lack of hospital beds and the temporary use of operating rooms and post-anesthetic recovery rooms as ICU beds [7].…”

Section: Introductionmentioning

confidence: 99%

Impact of the Covid-19 Pandemic on Otolaryngology Residency Training: A Cross-Sectional Study

Sánchez‐Gómez

Maza‐Solano

López-Flórez

et al. 2021

Preprint

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BackgroundTraining in surgical specialties has declined during the COVID-19 pandemic. A study was carried out to further analyze the impact of the COVID-19 pandemic on specific aspects of clinical, training, and research activities performed by the otolaryngology residents in Spain.MethodsA cross-sectional qualitative study was conducted during the last two weeks of February 2021. The study consisted of an online survey taken by otolaryngology residents who had undertaken one-year continuing training from February 15, 2020 to February 15, 2021 and consisted of 26 questions exploring the impact of the COVID-19 on the health of the ENT residents and training activities. Categorical variables were reported as frequency and percentage. When indicated, Pearson´s Chi-square test (c2) with Yates´s correction and Pearson's correlation coefficient (r) were used.Results143 completed surveys were received from 264 Residents (54.17%). 36 residents (25.2%) have suffered from the disease due to SARS-CoV-2. Most of them only developed mild symptoms (86.1%), with 3 requiring hospitalization (8.3%). The origin of infection was unknown in all cases and the need for confinement was principally due to either attending an asymptomatic patient in 9 cases (6.3%) or to being in close contact with an asymptomatic person off hospital grounds in 22 (15.4%). 60.1% of the residents surveyed reported having lost more than 6 months of their training period, and in 18.8% of cases, it was as high as 10 and 12 months. There has been a reduction of more than 75% of what was planned in surgical training (p < 0.05) of tympanoplasty, mastoidectomy, stapedectomy, cochlear implants, endoscopic sinonasal and anterior skull base surgery, septoplasty and turbinoplasty.ConclusionsThe decline in ENT activity and residents having to assist in other COVID-19 units during the most critical moments of the pandemic, has caused the main reduction in their training capacity. Virtual activities have been widely accepted, but they have not completely replaced all residents’ training needs. Specialized ENT training should be extended from 6 months to 1 year to ensure adequate training, especially for recovering the surgical Otology and Rhinology hands-on training lost during the pandemic.

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Estrategias para la práctica de la otorrinolaringología y cirugía de cabeza y cuello durante la fase de control de la COVID-19

Cited by 8 publications

References 41 publications

Explorando Los Sentidos: Un Viaje Por La Otorinolaringologia

Explorando Los Sentidos: Un Viaje Por La Otorinolaringologia

Dysphagia and Mechanical Ventilation in Sars-Cov-2 Pneumonia: It’s Real

Impact of the Covid-19 Pandemic on Otolaryngology Residency Training: A Cross-Sectional Study

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