The nose lid for the endoscopic endonasal procedures during COVID-19 era: technical note.
Acta Neurochir (Wien)
; 162(10): 2335-2339, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-709820
ABSTRACT
BACKGROUND:
COVID-19 pandemic has disrupted the global health systems worldwide. According to the tremendous rate of interhuman transmission via aerosols and respiratory droplets, severe measures have been required to contain contagion spread. Accordingly, medical and surgical maneuvers involving the respiratory mucosa and, among them, transnasal transsphenoidal surgery have been charged of maximum risk of spread and contagion, above all for healthcare professionals.METHOD:
Our department, according to the actual COVID-19 protocol national guidelines, has suspended elective procedures and, in the last month, only three patients underwent to endoscopic endonasal procedures, due to urgent conditions (a pituitary apoplexy, a chondrosarcoma causing cavernous sinus syndrome, and a pituitary macroadenoma determining chiasm compression). We describe peculiar surgical technique modifications and the use of an endonasal face mask, i.e., the nose lid, to be applied to the patient during transnasal procedures for skull base pathologies as a further possible COVID-19 mitigation strategy.RESULTS:
The nose lid is cheap, promptly available, and can be easily assembled with the use of few tools available in the OR; this mask allows to both operating surgeon and his assistant to perform wider surgical maneuvers throughout the slits, without ripping it, while limiting the nostril airflow.CONCLUSIONS:
Transnasal surgery, transgressing respiratory mucosa, can definitely increase the risk of virus transmission we find that adopting further precautions, above all limiting high-speed drill can help preventing or at least reducing aerosol/droplets. The creation of a non-rigid face mask, i.e., the nose lid, allows the comfortable introduction of instruments through one or both nostrils and, at the same time, minimizes the release of droplets from the patient's nasal cavity.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pituitary Neoplasms
/
Pneumonia, Viral
/
Pituitary Apoplexy
/
Chondrosarcoma
/
Coronavirus Infections
/
Endoscopes
/
Masks
Type of study:
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Acta Neurochir (Wien)
Year:
2020
Document Type:
Article
Affiliation country:
S00701-020-04518-z
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