McCarty E Berryhill, Soldatova Liuba, Brant Jason A, Newman Jason G
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, PA, USA.
World J Otorhinolaryngol Head Neck Surg. 2021 Jan 22;8(3):224-38. doi: 10.1016/j.wjorl.2021.01.001.
Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that need.
PubMed, Ovid/Medline, and Scopus.
A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.
A total of 41 papers met inclusion criteria and were organized into 5 categories ('General Recommendations for Otolaryngologic Surgery', 'Equipment Shortage Solutions', 'Airway Procedures', 'Nasal Endoscopy and Skull Base Procedures', and 'Otologic Procedures'). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 transmission.
Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically. This review examines and organizes creative solutions that have been proposed and utilized in the otolaryngology. These solutions have a potential to minimize the risk of viral transmission in the current clinical environment and to create safer outpatient and operating room conditions for patients and healthcare staff.
由于在耳科、鼻腔和口咽检查及手术过程中接触呼吸道飞沫和气溶胶，耳鼻喉科医生感染2019冠状病毒病（COVID-19）的职业风险增加。已经制定了各种指南和预防措施来帮助降低这种风险。虽然许多综述都集中在COVID-19时代手术的个人防护设备（PPE）和准备指南上，但没有一篇关注旨在限制病毒传播的更具创造性和不寻常的解决方案。本综述旨在满足这一需求。
PubMed、Ovid/Medline和Scopus。
2020年9月28日，使用PubMed、Ovid/Medline和Scopus数据库对文献进行了全面综述。如果所有英文研究提出或评估了在COVID-19大流行期间为耳鼻喉科实践开发的新干预措施，则将其纳入。遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。
共有41篇论文符合纳入标准，并分为5类（“耳鼻喉科手术的一般建议”、“设备短缺解决方案”、“气道手术”、“鼻内镜和颅底手术”以及“耳科手术”）。对文章进行了总结，突出了在COVID-19大流行期间创造和评估的创新。已经开发出了一些创造性的解决方案，如局部使用杀病毒剂、临时口罩过滤器、用于头灯的三维（3-D）可打印适配器、含气溶胶分离箱以及各种新的铺巾技术，以限制COVID-19传播风险。
COVID-19暴露的持续风险仍然很高。因此，越来越需要能够降低门诊手术和外科手术期间病毒传播风险的解决方案，特别是考虑到大多数COVID-19阳性患者无症状。本综述研究并整理了耳鼻喉科中已提出和采用的创造性解决方案。这些解决方案有可能在当前临床环境中最大限度地降低病毒传播风险，并为患者和医护人员创造更安全的门诊和手术室条件。
