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Otol Neurotol ; 42(3): e378-e379, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1109359


OBJECTIVE: The recent COVID-19 pandemic has required careful reconsideration of safe operating room practices. We describe our initial experiences performing otologic surgery with the exoscope during the COVID-19 pandemic. METHOD: The exoscope was used for several semiurgent otologic surgeries in combination with complete eye protection, a "tent" drape, a smoke evacuator with ultra-low particulate air filter, and betadine irrigation. These techniques are demonstrated in the accompanying video. This was compared with our experiences using the microscope. RESULTS: The described modified goggles allowed complete eye protection while providing a fully three-dimensional view of the surgical site. The other safety measures described are simple and efficient techniques which can easily be adopted for otologic surgery using the microscope. CONCLUSION: Use of the exoscope for otologic surgery during the COVID-19 pandemic allows full three-dimensional visualization of the surgical field while simultaneously providing complete eye protection. Use of the "tent" drape, ultra-low particulate air filter, and betadine irrigation are also options that otologic surgeons may consider for additional safety.

COVID-19/prevention & control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Microscopy/instrumentation , Microscopy/methods , Otologic Surgical Procedures/instrumentation , Otologic Surgical Procedures/methods , Humans , Imaging, Three-Dimensional , Mastoidectomy/instrumentation , Mastoidectomy/methods , Pandemics , Personal Protective Equipment , SARS-CoV-2
Otolaryngol Head Neck Surg ; 165(1): 89-92, 2021 07.
Article in English | MEDLINE | ID: covidwho-977600


This study compares nasopharyngeal and tracheal samples for COVID-19 viral testing in patients with a tracheostomy. This was a prospective cohort study done at 2 academic hospitals between March and June 2020. Patients admitted through the emergency department who had a COVID-19 test and an existing tracheostomy or underwent a tracheostomy during the admission period were included. Patients with a positive initial nasopharyngeal swab were placed in the experimental group (n = 8), while those with a negative swab were the control group (n = 7). Nasopharyngeal and tracheal samples underwent COVID-19 testing using the Abbott RealTime SARS-CoV-2 RNA assay. Fourteen patients underwent tracheostomy, and 1 had an existing tracheostomy. The average duration of viral shedding in nasopharyngeal samples was 20.9 days. One patient (6.7%) tested positive in tracheal secretions after a negative nasopharyngeal swab. In the remaining patients (93.3%), the nasopharyngeal and tracheal specimens correlated.

Bodily Secretions/chemistry , COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , Nose , Pharynx , RNA, Viral/analysis , SARS-CoV-2/genetics , Trachea , Adult , Aged , COVID-19/therapy , Female , Humans , Male , Middle Aged , Prospective Studies , Tracheostomy