Innovations in otorhinolaryngology in the age of COVID‐19: A systematic literature review

McCarty, E. Berryhill; Soldatova, Liuba; Brant, Jason A.; Newman, Jason G.

doi:10.1016/j.wjorl.2021.01.001

Cited by 9 publications

(7 citation statements)

References 72 publications

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“…Environmental protection uses commonly available surgical drapes and other equipment traditionally present in the OR. It is important to note that most of the proposed methods are prototypes (McCarty et al, 2021), and have not yet been rigorously proven.…”

Section: Environmental Protectionmentioning

confidence: 99%

Otitis Media Practice During the COVID-19 Pandemic

Marom¹,

Pitaro

Shah

et al. 2022

Front. Cell. Infect. Microbiol.

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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.

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Section: Environmental Protectionmentioning

confidence: 99%

Otitis Media Practice During the COVID-19 Pandemic

Marom¹,

Pitaro

Shah

et al. 2022

Front. Cell. Infect. Microbiol.

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“…In response to the COVID-19 pandemic, a variety of innovative face masks and shields were developed to mitigate the risk of transmission during endoscopic exams and procedures. 7 Studies by Anon et al and Davies et al showed that 3D-printed endoscopy masks and enhanced face shields, respectively, prevented the spread of gross droplets, visualized by fluorescent dye, after a simulated cough. 11,12 Others have shown that in cadaveric models, modified versions of N95 and Ambu respirators, particularly when fitted with suctioning devices to create negative pressure environments, permit endoscopic instrumentation while limiting aerosol spread.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have similarly reported the use of negative-pressure microenvironments and modified N95 masks to decrease aerosol dispersion during endoscopic procedures. 7 Here, we present the results of a prospective clinical trial on 100 consecutive clinic patients who underwent medically necessarily endoscopy while wearing the ACM. We showed that the ACM can accommodate rigid nasal and flexible endoscopes and prevent leakage of patientgenerated aerosols.…”

mentioning

confidence: 99%

COVID‐19 in the Clinic: Trial of an Aerosol Containment Mask for Endoscopic Clinic Procedures

Ference,

Kim,

Oghalai

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveCreate an aerosol containment mask (ACM) for common otolaryngologic endoscopic procedures which also provides nanoparticle‐level protection to patients.Study DesignProspective feasibility study.SettingIn‐person testing with a novel ACM.MethodsThe mask was designed in Solidworks and 3‐dimensional printed. Measurements were made on 100 consecutive clinic patients who underwent medically necessarily endoscopy, 50 rigid nasal and 50 flexible, by 9 surgeons.ResultsOf the 50 patients who underwent rigid nasal endoscopy with the ACM, 0 of 25 patients with the suction off and 0 of 25 patients with the suction on had evidence of leakage of 0.3 μm particles. Of the 50 patients who underwent flexible endoscopy with the ACM, 0 of 25 patients with the suction off and 0 of 25 patients with the suction on had evidence of leakage of 0.3 μm particles. In terms of comfort, 73% of patients found the ACM somewhat or very comfortable without suction, compared to 86% with the suction on. Surgeons were able to visualize all necessary anatomic areas in 98% of procedures. In 97% of procedures, the masks were able to be placed easily.ConclusionACM can accommodate rigid nasal and flexible endoscopes and may prevent leakage of patient‐generated aerosols, thus avoiding contamination of the room and protecting health care workers from airborne contagions.Level of EvidenceThe level of evidence is 2.

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“…A number of different patient masks for trans-nasal endoscopic procedures have been developed and tested in various conditions. 39 Specifically for flexible laryngoscopy, Hoffman et al utilized an acrylic box with sealable ports of differing sizes and required a disposable drape and suction machine with a HEPA filter to create a negative pressure environment around the patient's head. The researcher reported good patient tolerance with nonsignificant changes in pulse oximetry recordings; however, no aerosolization testing was performed.…”

Section: Discussionmentioning

confidence: 99%

Patient‐worn endoscopy mask to protect against viral transmission

Vahabzadeh‐Hagh

Patel

Weissbrod

2021

Laryngoscope Investig Oto

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Objectives: To design and evaluate patient-worn personal protective equipment (PPE) that allows providers to perform endoscopy while protecting against droplet and airborne disease transmission.Study design: Single subject study.Methods: Mask efficacy was evaluated using a cough simulator that sprays dye visible under ultra-violet light. User-testing was performed on an airway trainer mannequin where each subject performed the endoscopy with and without the mask in random orders. Their time to completion and number of attempts before successful completion were recorded, and each subject was asked to fill out a NASA Task Load Index (TLX) form with respect to their experience. Results:The mask has a filtration efficiency of 97.31% and eliminated any expelled particles with the cough simulator. Without the mask, a simulated cough is visualized as it progresses away from the cough origin. Subjects who performed trans-nasal endoscopy spent 27.8 ± 8.0 s to visualize the vocal cords for the no mask condition and 28.7 ± 13.6 s for the mask condition (mean ± SD, p > .05). There was no statistically significant difference found in the mental demand, physical demand, temporal demand, performance, effort, and frustration of endoscopy under the no mask and mask conditions (all p > .05). Conclusion:The designed PPE provides an effective barrier for viral droplet and airborne transmission while allowing the ability to perform endoscopy with ease.

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Innovations in otorhinolaryngology in the age of COVID‐19: A systematic literature review

Cited by 9 publications

References 72 publications

Otitis Media Practice During the COVID-19 Pandemic

Otitis Media Practice During the COVID-19 Pandemic

COVID‐19 in the Clinic: Trial of an Aerosol Containment Mask for Endoscopic Clinic Procedures

Patient‐worn endoscopy mask to protect against viral transmission

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