The Royal London Hospital, London, UK.
Queen Elizabeth University Hospital, Glasgow, UK.
J Int Adv Otol. 2022 Jul;18(4):347-357. doi: 10.5152/iao.2022.21482.
To assess compliance with guidance produced by the UK body representing all ENT Surgeons (ENT UK) and the British Society of Otology (BSO) on restarting otological surgery after the first wave of the COVID-19 pandemic. Safety was assessed by recording surgical complica- tions and transmission of SARS-CoV-2 transmission during this period.
A prospective multicenter audit of otological surgery was conducted over a 12-week period, from June 15, 2020, to September 6, 2020.
One thousand one hundred thirty cases from 79 hospital sites across Great Britain were involved in the study; 91.1% were tested for SARS-CoV-2 pre-operatively, none of whom tested positive; 70.4% were isolated for 7-14 days prior to surgery; 28.2% of surgeons wore full personal protective equipment, compared with 66.6% of anesthetists and 68.2% of scrub staff. The endoscope was used in 75 (6.7%) of all proce- dures, operations were changed to be performed under local rather than a general anesthetic in 3 cases (0.3%) and the "double drape" to protect against aerosol was used in 321 (27.4%) of cases. Trainees were present in 80.3% of cases. Complications occurred in 4% of cases. No patients or staff contracted SARS-CoV-2 during the audit.
ENT UK and BSO guidance was variably followed, with the highest compliance for the use of an FFP3 mask, a negative SARS-CoV-2 swab, and trainee presence in theater. Surgeons did not use full personal protective equipment as frequently as their anesthetic and scrub team colleagues. There were only minimal changes in surgical and anesthetic techniques. Otological operation after the first wave of the SARS- CoV-2 pandemic was performed safely with no reported COVID transmission or increase in major complications despite changes in operating practice.
评估英国耳鼻喉科医师协会（ENT UK）和英国耳科学会（BSO）为应对 COVID-19 大流行第一波后重启耳科手术而发布的指南的执行情况。在此期间，通过记录手术并发症和 SARS-CoV-2 传播情况来评估安全性。
在 2020 年 6 月 15 日至 9 月 6 日的 12 周内，对英国 79 家医院的 1130 例耳科手术进行了前瞻性多中心审计。
研究涉及英国 79 家医院的 1130 例病例；91.1%的患者术前接受了 SARS-CoV-2 检测，均为阴性；70.4%的患者在术前 7-14 天进行隔离；28.2%的外科医生佩戴了全套个人防护设备，而麻醉师和手术助手的这一比例分别为 66.6%和 68.2%。在所有手术中，有 75 例（6.7%）使用了内窥镜，3 例（0.3%）手术改为局部麻醉而不是全身麻醉，321 例（27.4%）使用了“双层覆盖”以防止气溶胶传播。80.3%的手术有学员在场。4%的病例出现并发症。在审计期间，没有患者或工作人员感染 SARS-CoV-2。
英国耳鼻喉科医师协会和英国耳科学会的指南执行情况存在差异，其中使用 FFP3 口罩、SARS-CoV-2 检测阴性和学员在手术室的规定执行情况最好。外科医生没有像麻醉师和手术助手的同事那样频繁地使用全套个人防护设备。手术和麻醉技术仅发生了最小的变化。尽管手术操作有所改变，但在 COVID-19 大流行第一波后开展耳科手术是安全的，没有报告 COVID 传播或主要并发症增加。
