Eye protection in ear, nose and throat surgery

Prior, Andrew; Montgomery, P. Q.; Srinivasan, V.

doi:10.1017/s0022215100123874

Cited by 14 publications

(8 citation statements)

References 3 publications

(5 reference statements)

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“…In two of these studies, the risk of conjunctival contamination of the surgeon was assessed by counting visible blood spots on goggles or safety spectacles. 7,8 The rates of blood contamination were 15 and 22 per cent, respectively. The first study included 108 tonsillectomies and found that using ties, as opposed to bipolar diathermy, for haemostasis resulted in a decreased risk of conjunctival contamination.…”

Section: Discussionmentioning

confidence: 98%

“…11 Just as it is important to determine the risks of different surgical procedures for patients, it is also important for surgeons to know the risks they themselves are exposed to. Although Keogh et al 8 published their results eight years after Prior et al 7 first drew attention to the risk of conjunctival contamination of the surgeon during tonsillectomy, none of the ENT surgeons surveyed by Keogh et al routinely wore eye protection during tonsillectomy, other than spectacles. Attention therefore needs to continue to be drawn to the risk of conjunctival contamination during tonsillectomy, and surgeons should be aware of which procedures or instruments place them at greater risk.…”

Section: Discussionmentioning

confidence: 99%

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Blood splash from different diathermy instruments during tonsillectomy

et al. 2006

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Blood splash from different diathermy instruments during tonsillectomy

et al. 2006

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“…In our center, however, the endovascular treatment after failure of conservative measure is routine, which emerged also from the discussion with our otorhinolaryngologists. It has been investigated that there is a high risk of contamination of medical staff with patient`s blood during surgery [27,28]. Since we are frequently asked to treat epistaxis, we developed a protocol with high safety standards to avoid CVA.…”

Section: Discussionmentioning

confidence: 99%

Not All Embolizations Are Created Equally in the Management of Posterior Epistaxis: Discussion of Safety Measures Avoiding Neurological Complications

Franke

Franke²,

Saager³

et al. 2020

Radiology Research and Practice

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Today, there are still no uniform guidelines for the treatment of epistaxis. Furthermore, it is widely debated whether embolization or surgical approaches should be the first choice of treatment for intractable posterior epistaxis after conservative measures have failed. In several meta-analyses, it is reported that endoscopic sphenopalatine artery ligation and embolization have similar success rates, but embolization was associated with more severe neurological complications. Regarding existing literature, there are many comparative analyses of surgical methods but none for embolization protocols. Against this backdrop of a lack of uniform standards in embolization techniques, we present a retrospective evaluation of what has emerged to be best procedural practice for endovascular treatment of epistaxis in our department using microsphere particles and microcoils, in particular regarding precaution measures to avoid neurological complications. In our retrospective data analysis of 141 procedures in 123 patients, performed between 2008 and 2019, we find success rates very similar to those reported in other studies (95.1% immediate-stop-of-bleeding success and 90.2% overall embolization success) but did not encounter any major neurological complication opposed to other reports. We suggest some aspects of our protocol as precaution measure to avoid neurological complications. More generally and perhaps even more importantly, we make a strong case for standardization for embolization techniques to the level of details in surgical procedure standardization to enable an apples to apples comparison of embolization techniques to each other and of intervention vs. surgery.

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“…[10] Inoculation of the conjunctiva by the patient's blood may cause transmission of HBV, HCV, and HIV infections [11,12] and this may occur while performing tonsillectomy procedure. [13][14][15] Lakhani et al [10] examined the degree and incidence of blood splashes in otolaryngology procedures performed in their unit for 12 weeks. They wore a mask with a visor and examined the masks for blood splash.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of HBV, HCV, and HIV positivity in patients undergoing tonsillectomy

Kırgezen¹

2019

KBB Uygulamaları

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Bu çalışmada tonsillektomi yapılan hastalarda hepatit B virüsü (HBV), hepatit C virüsü (HCV) ve insan immün yetmezlik virüsü (HIV) seroprevalansı araştırıldı. Hastalar ve Yöntemler: Ocak 2012-Aralık 2018 tarihleri arasında kliniğimizde genel anestezi altında iki taraflı tonsillektomi yapılan toplam 751 hasta (389 erkek, 362 kadın; ort. yaş 27 yıl; dağılım, 12-58 yıl) retrospektif olarak incelendi. Tüm hastalarda hepatit B yüzey antijeni (HBsAg), anti-HCV ve anti-HIV seropozitifliği araştırıldı. Bulgular: Sekizi erkek (%1) ve dördü kadın (%0.5) olmak üzere 12 hastada HBsAg seroloji pozitifliği tespit edildi. İki erkek hastada (%0.2) anti-HCV pozitifliği ve iki erkek hastada (%0.2) anti-HIV pozitifliği izlendi. Yaş gruplarına göre (≤18 yaşa kıyasla >18 yaş), seroloji pozitifliği olan hastaların tümü >18 yaşında idi. Sonuç: Tonsillektomi öncesi, özellikle 18 yaş üzerindeki ve erkek hastalarda, ameliyat öncesi HBV, HCV ve HIV seroloji testi gereklidir. Kulak, burun, boğaz hekimleri mesleki maruziyet ile bulaş riski açısından dikkatli olmalı ve özellikle bu tür ameliyatları yaparken maske veya gözlük takarak bulaşa karşı kendilerini korumak amacıyla gerekli tedbirleri almalıdır. Anahtar sözcükler: Hepatit B virüsü, hepatit C virüsü, insan immün yetmezlik virüsü, seroprevalans, tonsillektomi. ABSTR ACT Objectives: This study aims to investigate the seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) in patients undergoing tonsillectomy. Patients and Methods: Between January 2012 and December 2018, a total of 751 patients (389 males, 362 females; mean age 27 years; range, 12 to 58 years) who underwent bilateral tonsillectomy under general anesthesia in our clinic were retrospectively analyzed. The seropositivity of hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV was investigated in all patients. Results: Positive serology for HBsAg was detected in 12 patients (1.5%) including eight males (1%) and four females (0.5%). Two male patients (0.2%) and two male patients (0.2%) had anti-HCV positivity and anti-HIV positivity, respectively. According to the age groups (≤18 vs. >18 years), all serology-positive patients were >18 years of age. Conclusion: Testing of the HBV, HCV, and HIV serology is necessary for tonsillectomy patients preoperatively, particularly those who are older than 18 years and males. All otolaryngologists should be aware of transmission via occupational exposure and must take necessary precautions to protect themselves against contamination by wearing a mask or goggles, particularly while performing such operations.

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Eye protection in ear, nose and throat surgery

Cited by 14 publications

References 3 publications

Blood splash from different diathermy instruments during tonsillectomy

Blood splash from different diathermy instruments during tonsillectomy

Not All Embolizations Are Created Equally in the Management of Posterior Epistaxis: Discussion of Safety Measures Avoiding Neurological Complications

Seroprevalence of HBV, HCV, and HIV positivity in patients undergoing tonsillectomy

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