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Endoscopic Skull Base and Transoral Surgery During COVID-19 Pandemic: Minimizing Droplet Spread with Negative-pressure Otolaryngology Viral Isolation Drape

Overview
Journal Head Neck
Specialties General Surgery
Oncology
Date 2020 May 3
PMID 32358853
Citations 30
Authors
Abel P David
Nicole T Jiam
Joshua M Reither
Jose G Gurrola 2nd
Manish K Aghi
Ivan H El-Sayed
Affiliations
Soon will be listed here.
Abstract

Background: The coronavirus disease (COVID-19) pandemic has raised concern of transmission of infectious organisms through aerosols formation in endonasal and transoral surgery.

Methods: Retrospective review. We introduce the negative-pressure otolaryngology viral isolation drape (NOVID) system to reduce the risk of aerosol. NOVID consists of a plastic drape suspended above the patient's head and surgical field with a smoke evacuator suction placed inside the chamber.

Results: Four patients underwent endonasal (4) and endo-oral surgery (1). Fluorescein was applied to the surgical field. Black light examination of fluorescein-treated operative fields revealed minimal contamination distant to the surgical field. In two prolonged cases with high-speed drilling, droplets were identified under the barrier and on the tip of the smoke evacuator. Instruments and cottonoids appeared to be a greater contributor to field contamination.

Conclusions: Negative-pressure aspiration of air under a chamber barrier, which appears to successfully keep aerosol and droplet contamination to a minimum.

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