<p class="abstract">Tuberculosis is one of the most common treatable infectious disease in India. Most common presentation being pulmonary tuberculosis. Primary tuberculosis of maxillary sinus leading to chronic otitis media is an extremely rare entity, diagnosis of which is often delayed and resulting in delay in start of actual treatment. The following report highlight a case of 63 years male patient presented with bilateral ear discharge, not responding to the routine antibiotic therapy. CT scan imaging denoted left pansinusitis with osteomyelitic changes in left maxillary sinus with otitis media. The diagnosis was confirmed by histopathological biopsy report. The patient was treated with Anti-tubercular regimen for 9 months and following which bilateral tympano-mastoidectomy was done.</p>
Background Coronavirus disease 2019 was first identified in Wuhan, the capital of China’s Hubei province, in December 2019. India has witnessed a massive surge of coronavirus cases. Main text This study details the measures to be taken by the clinicians involved in doing otorhinolaryngology and head neck surgery in light of the recent coronavirus disease 2019 pandemic. All COVID-positive patients should be admitted in a separate COVID ward, and patients should be screened for COVID-19 before admission. Only emergent ENT surgeries should be done in an operating room having a negative pressure environment with high-frequency air changes, and all staff must wear personal protective equipment. The anesthetist intubates the patient while the surgical team waits outside the operation theater post-intubation for 21 min. For otology surgery, double draping of the microscope should be done; for rhinology surgery, concept of negative-pressure otolaryngology viral isolation drape (NOVID) system should be used. Smoke evacuation system is set up inside the tent to evacuate any smoke produced during the surgery. Tracheostomy should be done at least after 10 days of mechanical ventilation with cuffed, non-fenestrated tracheal tube inserted through the tracheal window, and a separate closed suction system is used for suctioning. After the surgery is completed, disposal of PPE kit needs to be done according to local guidelines. After completion of the surgery, the full anesthesia unit should be disinfected for 2 h with 12 % hydrogen peroxide. Chlorine-containing disinfectant (2000 mg/L) is used to clean the floor of the operation theater and clean all the reusable medical equipment. Ultra-low volume 20 to 30 mL/m of 3% hydrogen peroxide is used to fumigate the OT for 2 h. Conclusions COVID-19 is a newly discovered infectious disease. Measures need to be taken to prevent transmission and attain a plateau and decline in the disease. Otorhinolaryngologists and head neck surgeons are at high risk of this infection. This review summarizes the protocol for otorhinolaryngologists and head neck surgeons caring for patients in this current scenario. Protocols need to be strictly followed to prevent the spread of this disease.
<p class="abstract">Measures to be taken by the clinicians involved in Otology surgery in light of the recent COVID-19 pandemic. Current finding about COVID-19 infection and its relation with SARS-CoV 2 virus is evaluated and possible safety measure guidelines to be taken while doing Otological procedures is reviewed. Wearing PPE kit (N95 mask, double gloves, respirator, eye protection, face shield, gown, shoe cover ), limited attendance to essential personnel, using negative pressure room, using double drape system and proper removal of patient drape after rhinology operation reduces the risk of SARS-CoV 2 virus spread via aerosol into the environment. Emergent and Urgent otology surgery need prompt treatment, thus proper COVID-19 protocols should be maintained while doing otology surgery like wearing PPE ( N95 mask, double gloves, respirator, eye protection, face shield, gown, shoe cover ), limit attendance to essential personnel and use negative pressure room are undertaken. Double draping of the operating site is essential while drilling and suctioning and it’s too carried out under the plastic tent to reduce aerosol spread in the environment. Proper removing of the tent setup, including rolling of patient drape is needed to reduce aerosol spread. Otology surgeries should adhere to general guidelines set for high-risk procedures.</p>
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