Nasal, pharyngeal and laryngeal endoscopy procedures during COVID-19 pandemic: available recommendations from national and international societies

Luca, Pietro De; Scarpa, Aldo; Ralli, Massimo; Vincentiis, Marco de; Cassandro, Ettore; Chiarella, Giuseppe; Cassandro, Claudia

doi:10.1007/s00405-020-06028-1

Cited by 34 publications

(42 citation statements)

References 9 publications

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“…In the context of the ongoing coronavirus pandemic, a majority of professional bodies have recognized officebased surgery as a high-risk aerosol-generating procedure, [15][16][17][18][19][20] and in the authors' view, it is difficult to overstate the importance of adequate personal protective equipment and ventilation. In our institution, all team members present during surgery wear powered air-purifying respirator hoods in addition to full-length gown and gloves ( Figure 1).…”

Section: Laser and Office-based Procedures Safety In The Context Of Comentioning

confidence: 99%

Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

2020

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Background: The recent introduction of 445 nm blue laser to office-based laryngology presents potential advantages. These include a desirable combination of cutting and photoangiolytic qualities and a lightweight, shock-resistant design. Despite its increasing use, current evidence is limited to experimental data and case reports. Objectives: The authors present a case series and overview of office blue laser transnasal flexible laser surgery (TNFLS), considering indications, patient selection, safety, technique, and surgical outcomes. We also review the safety and relevance of TNFLS to the ongoing coronavirus pandemic. Methods: Retrospective case series and narrative review. Our primary outcome measure was preoperative and postoperative Voice Handicap Index (VHI-10) score. Complications were documented by nature and severity. Results: Thirty-six cases of office blue laser TNFLS were performed. A statistically significant improvement in VHI-10 score was demonstrated in cases of recurrent respiratory papillomatosis (RRP) and benign laryngeal lesions causing dysphonia ( P < 0.01 and 0.045). Blue laser also proved effective in assisting office biopsy procedures. A minor and self-limiting complication was reported. Conclusions: Office blue laser TNFLS is safe and effective in the treatment of RRP and a range of benign laryngeal lesions. Future research should compare the efficacy and safety of blue laser with potassium titanyl phosphate laser in office-based treatment of these conditions. Further assessment of the cutting qualities of blue laser, initially in the theater environment, is necessary to refine our understanding of future applications.

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Section: Laser and Office-based Procedures Safety In The Context Of Comentioning

confidence: 99%

Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

2020

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“…During the COVID-19 pandemic, most national and international Otorhinolaryngology and Cervical-Facial Surgery societies tend to consider laryngoscopy as strictly necessary only in critical cases, since its performance has direct impact on patients’ management 28 , 34 ; however, it is mandatory performing the efficient screening of possible infected individuals, using PPE and maintaining distance from patients in all steps before the procedure. 28 , 34 On the other hand, the literature lacks proposals to optimize the use of this equipment, by maintaining reprocessing with isopropyl alcohol and glutaraldehyde, 28 , 34 which have strong potential to damage the integrity of telescopes currently usedfor laryngoscopy purposes. This conflicting scenario reinforces the importance of conducting research about the use of protection caps and barrier methods, such as the herein conducted one.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Quality of Rigid Optic Videolaryngoscopy Image Taken Through Dental Protection Cap and Its Feasibility as Additional Barrier Method Against COVID-19

et al. 2023

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Videolaryngoscopyscreening is essential to help assessing human larynx. The use of 70° optical fiber in association with image recording by analog or digital cameras is one of the methods adopted to perform this examination. Endoscopic exams can contaminate the equipment with several microorganisms.The pandemic caused by the new coronavirus (SARS-CoV-2) reinforces the importance of developing efficient barrier methods to be adopted in videolaryngoscopy procedures. Although dental intraoral camera covers are a barrier method authorized by Brazilian health organs, it has not yet been used in videolaryngoscopy examinations. The aim of the current longitudinal, individualized, single-blind, prospective, self-controlled and accurate study is to evaluatethe quality of images generated through, and confidence level of,diagnosis based on videolaryngoscopyperformed with intraoral dental camera equipped with disposableprotection cap and connected to 70° rigid laryngoscope in vocally healthy individuals.Videolaryngoscopy examinations based on 70° rigid optics were performed in 13 euphonic and asymptomatic volunteers at an otorhinolaryngology specialist clinic; only one patient was excluded from the study. Images were taken with, and without, disposable intraoraldental cameraprotection cap; high-grade disinfection protocol was applied between examinations. Recorded videos were randomly distributed in a single-blind manner in order tobe evaluated by four otorhinolaryngologists, who answered a questionnaire comprising three questions. Statistical analysis was used to compare groups – which were defined by the use, or not, of protection cap - based on Wilcoxon non-parametric test. Statistical significance was set at 5% with 95% confidence interval. There was no statistically significant difference in image quality between examinations performed with, and without, protection cap (p = 0.646) or in the diagnosis confidence level of examinations performed with, or without, the barrier method. The use of disposable protection cap on intraoral dental camera did not significantly change the quality of imagestaken throughvideolaryngoscopy performed with 70° rigid optics in vocally healthy patients.

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“…In order to support clinicians in daily practice during COVID-19 pandemic, several guidance documents have been written by bodies of different professions in different areas of the world [ 3 – 6 , 8 , 9 , 17 – 21 ]. All published documents recommend the use of PPE for live management of dysphagia in COVID+ve patients and encourage compensatory treatments and telepractice.…”

Section: Discussionmentioning

confidence: 99%

ESSD Commentary on Dysphagia Management During COVID Pandemia

et al. 2020

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Since the World Health Organization declared the COVID-19 pandemic a Global Public Health Emergency, experts in swallowing are seeking guidance on service delivery and clinical procedures. The European Society for Swallowing Disorders provides considerations to support experts in swallowing disorders in clinical practice. During the COVID-19 pandemic, assessment and treatment of patients with oropharyngeal dysphagia should be provided, while at the same time balancing risk of oropharyngeal complications with that of infection of patients and healthcare professionals involved in their management. Elective, non-urgent assessment may be temporarily postponed and patients are triaged to decide whether dysphagia assessment is necessary; instrumental assessment of swallowing is performed only if processing of the instruments can be guaranteed and clinical assessment has not provided enough diagnostic information for treatment prescription. Assessment and management of oropharyngeal dysphagia is a high-risk situation as it must be considered an aerosol-generating procedure. Personal protective equipment (PPE) should be used. Telepractice is encouraged and compensatory treatments are recommended.

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Nasal, pharyngeal and laryngeal endoscopy procedures during COVID-19 pandemic: available recommendations from national and international societies

Abstract: Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Cited by 34 publications

References 9 publications

Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

Evaluating the Quality of Rigid Optic Videolaryngoscopy Image Taken Through Dental Protection Cap and Its Feasibility as Additional Barrier Method Against COVID-19

ESSD Commentary on Dysphagia Management During COVID Pandemia

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