Otology practice during COVID-19 era: a review of current practice

Abstract

Background The novel coronavirus started as an outbreak in Wuhan, China, in December 2019.The outbreak was declared a pandemic by the WHO on 12 March 2020. The virus is called SARS-CoV-2, and the virus-induced disease is called COVID-19. The infection spreads via droplets or direct contact with contaminated surfaces. Airborne transmission occurs during aerosol-generating procedures on patients. Many otologic procedures are considered AGPs and therefore require precautions to protect staff and patients and minimize transmission of the disease. Main body Outpatient otology activity has seen changes, including virtual clinics and limitation of face-to-face consultations, to ensure safety. Powered instrumentation should be avoided during surgical procedures unless necessary or replaced with other tools, and if performed, enhanced personal protective equipment (PPE) must be used. Ear, nose, and throat (ENT) examination is recommended for any patient with full PPE in place except for consultations done without examination. Systemic steroid administration for treating conditions such as Bell’s palsy and sudden sensorineural hearing loss should be discussed with both the patient and infectious diseases specialist to weigh risks against benefits. Triaging of patients and prioritization is unavoidable during the pandemic and even after due to the limitations of clinic and theater time. All emergency/urgent cases are considered potentially COVID-19 positive. For the semi-urgent and all elective cases, COVID-19 testing 48 h prior to surgery, strict quarantine awaiting test results, and repeat testing on day of surgery if rapid tests are available are the precautions suggested. Different measures should be in place to minimize staff potential exposure intraoperatively. Conclusions Otology practice has been affected by the COVID-19 pandemic. Various measures are in place to ensure the delivery of safe and effective service for patients and health care workers.

The impact of COVID-19 in the attendance of patients to the otolaryngology clinic: a retrospective review

“…Even so, this emerging virus posed a heightened threat towards healthcare workers, specifically in the field of Otolaryngology, who are routinely exposed to secretions during patient encounters. With many aerosolizing procedures within the realm of Otolaryngology, Otolaryngologists would be highly susceptible compared to some of their counterparts in the hospital as COVID is less transmissible unless an aerosol-generating procedure is being brought out [ 7 – 9 ]. Along with many other large academic centers in the region, Thammasat University Hospital delivered an institutive response towards the management of COVID-19 in an effort to minimize personnel exposure to infected patients and to reduce contact and, thus, minimize possible transmission within the hospital.…”

Caracterización de la cirugía electiva de oído en tiempos de Covid 19 en el Hospital Universitario Clínica San Rafael

“…Actualmente se han descrito diferentes opciones para realizar cirugías de oído durante la pandemía con el objetivo de disminuir los riesgos de contagio. En estas publicaciones se hace referencia a la utilización de equipos de protección personal, la utilización de una "tienda de campaña" durante el fresado, la irrigación de soluciones yodadas, el fresado a bajas revoluciones, la adecuada ventilación de salas de cirugía y el uso del exoscopio entre otras (31,32,33,34). Sin embargo, hasta la fecha no se han publicado registros del seguimiento al personal de salud ni a los pacientes que han participado en estas cirugías electivas de oído.…”