ABSTRACT
: Since the beginning of 2020, the world has been confronted by the Covid-19 pandemic. The lock-down aims to limit the circulation of the virus and thus avoid overwhelming healthcare systems. Healthcare workers have had to adapt by postponing consultation and surgical activities. Otolaryngologists are particularly exposed to infection from the upper airway where the virus is highly concentrated. Literature has previously reported other human coronaviruses in the middle ear and mastoid, suggesting a risk of infection to staff during ear surgery where aerosolizing procedures are usually used. The aim of this article is to propose a strategy for planning consultations and surgeries for ear and lateral skull base diseases, in the context of the current active evolution of the pandemic and of the future gradual recovery to normal practice.
Subject(s)
Coronavirus Infections/prevention & control , Occupational Exposure/prevention & control , Occupational Health , Otologic Surgical Procedures , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Computer Simulation , Disinfection , Ear, Middle/surgery , Hospitalization , Humans , Mastoid/surgery , Operating Rooms , Otolaryngologists , Outpatients , Preoperative Period , SARS-CoV-2 , Skull Base/surgery , Viral LoadABSTRACT
PURPOSE: Otolaryngologists have had to postpone the majority of surgical procedures in the current COVID-19 pandemic. Airborne transmission, beyond the projection of droplets from upper airways, expose healthcare workers to a risk of viral infection. Aerosol generating procedures (AGP) increase the risk of viral transmission to staff within the operating room. METHODS: Surgery of middle ear and mastoid is also considered an AGP, particularly mastoidectomy performed using a high-speed drill. The authors report their experience in endoscopic ear surgery as an alternative technique to reduce AGP in otologic procedures. RESULTS: Transcanal endoscopic ear surgery is a reliable technique used to manage many otologic conditions. CONCLUSION: The endoscopic approach may reduce the risk of viral transmission to operating room staff by reducing the need for mastoidectomy.