Optimizing Airway Surgery in COVID 19 Era

Kalita, Sanchita; Gogoi, Biswajit; Khaund, Gautam; Agarwal, Vivek; Borah, Partha Pratim; Dutta, Anup; Gogoi, Daisy

doi:10.1007/s12070-020-02326-6

Cited by 6 publications

(6 citation statements)

References 35 publications

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“…The high rate of transmission of SARS-COV-2 and its contagiousness to spread via droplets 4,20 made all aerosol-generating procedures such as that of the upper airways and oral cavity more dangerous 9 and placed otolaryngologists dealing with airway illnesses 30 and ENT surgeons 4 at the greatest risk of COVID-19 contraction and subsequent transmission because of high exposure 30 and droplet splatter contamination 9 .…”

Section: Risks Posed By Tonsillectomy In a Pandemicmentioning

confidence: 99%

“…New mitigation protocols required all surgical patients to be tested for the virus 48 hours before admission 4,6,32 , especially when surgeons would be in close contact with their oral or nasal cavities. However, initially, this was not easily possible as many low-income-to-middle-income countries (LMIC) like India did not have widespread availability of RT-PCR tests for COVID-19 detection 30 , and hence, the limited resources could not be spent on every surgical patient prophylactically. These logistical strains posed an added serious challenge to ENT specialists and otolaryngologists 30 .…”

Section: Prophylactic Sars-cov-2 Rt-pcr Testing and Its Limitationsmentioning

confidence: 99%

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Revisiting Tonsillectomy Practices in the Light of the COVID-19 Pandemic

2023

PJMD

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With the onset of the COVID-19 outbreak, a limited healthcare force catered to an ever-increasing number of COVID-19 patients on top of non-COVID-19 patients. Over two years after the pandemic, it is evident that medical practice must adapt to COVID-19 to ensure the provision of undeterred, quality medical care. This review intends to re-evaluate the Tonsillectomy protocols that we employed during COVID-19 and explore ways in which we might improve the safety of this frequently performed surgery even after the pandemic. A decrease in the frequency of tonsillitis was observed as lockdown and strict social distancing protocols were followed. Thus, it is concluded that tonsillectomies may be deferred unless urgent and in the best interest of the patient and medical workforce. However, when surgery is necessary, new mitigation strategies, like preoperative COVID-19 screening, minimizing intra-operative staff, widespread use of personal protective equipment (PPE), negative pressure operating rooms, and reducing postoperative hospital stay need to be incorporated into the safety protocols of airway surgeries and minimize aerosolization such as using SES (smoke evacuation system) during surgery and TORS (trans-oral robotic surgery). This narrative review covers an extensive literature review of papers on PubMed, Google Scholar and Medline that highlight the impact of the Pandemic on the surgical practice in patients of recurrent tonsillitis since December 2019. Keywords: Tonsillitis; Tonsillectomy; COVID-19; SARS-COV-2; Health Policy; Surgical Policy.

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Section: Risks Posed By Tonsillectomy In a Pandemicmentioning

confidence: 99%

Section: Prophylactic Sars-cov-2 Rt-pcr Testing and Its Limitationsmentioning

confidence: 99%

Revisiting Tonsillectomy Practices in the Light of the COVID-19 Pandemic

2023

PJMD

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“…Among the studies finally excluded, there were four studies without details on thyroid surgery (one set in Vietnam [16], one in Italy [17], one International [18], one in Italy-UK [19]), one relative Fig. 1 Flowchart of study selection process to an operated case of PTC [20], one regarding potential surgical candidates who underwent active surveillance [21]. Nine English language studies had appropriate data for systematic review [22][23][24][25][26][27][28][29][30].…”

Section: Study Selectionmentioning

confidence: 99%

Thyroid surgery during the COVID-19 pandemic: results from a systematic review

Scappaticcio

Maiorino

Iorio

et al. 2021

J Endocrinol Invest

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Purpose During the COVID-19 pandemic, elective thyroid surgery is experiencing delays. The problem is that the COVID-19 pandemic is ongoing. The research purposes were to systematically collect the literature data on the characteristics of those thyroid operations performed and to assess the safety/risks associated with thyroid surgery during the COVID-19 pandemic. Methods We used all the procedures consistent with the PRISMA guidelines. A comprehensive literature in MEDLINE (PubMed) and Scopus was made using ‘‘Thyroid’’ and “coronavirus” as search terms. Results Of a total of 293 articles identified, 9 studies met the inclusion criteria. The total number of patients undergoing thyroid surgery was 2217. The indication for surgery was malignancy in 1347 cases (60.8%). Screening protocols varied depending on hospital protocol and maximum levels of personal protection equipment were adopted. The hospital length of stay was 2–3 days. Total thyroidectomy was chosen for 1557 patients (1557/1868, 83.4%), of which 596 procedures (596/1558, 38.3%) were combined with lymph node dissections. Cross-infections were registered in 14 cases (14/721, 1.9%), of which three (3/721, 0.4%) with severe pulmonary complications of COVID-19. 377 patients (377/1868, 20.2%) had complications after surgery, of which 285 (285/377, 75.6%) hypoparathyroidism and 71 (71/377, 18.8%) recurrent laryngeal nerve injury. Conclusion The risk of SARS-CoV-2 transmission after thyroid surgery is relatively low. Our study could promote the restart of planned thyroid surgery due to COVID-19. Future studies are warranted to obtain more solid data about the risk of complications after thyroid surgery during the COVID-19 era.

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“…Therefore, patients were presumed to be COVID‐19 positive and protocols were applied universally 7 . Some of the widely used guidelines include: (1) limiting the number of personnel involved in the procedure, (2) performing tracheotomy in a controlled environment, with negative pressure capabilities if possible, and (3) wearing personal protective equipment (PPE) that helps guard against airborne transmission 8–10 . The protocols at our institution were adapted from those published by UK‐ENT authors 9 .…”

Section: Introductionmentioning

confidence: 99%

“…7 Some of the widely used guidelines include: (1) limiting the number of personnel involved in the procedure, (2) performing tracheotomy in a controlled environment, with negative pressure capabilities if possible, and (3) wearing personal protective equipment (PPE) that helps guard against airborne transmission. [8][9][10] The protocols at our institution were adapted from those published by UK-ENT authors. 9 Current literature demonstrates that following safety recommendations decreases the spread of infection to healthcare workers.…”

Section: Introductionmentioning

confidence: 99%

Quality tracheotomy care can be maintained for non‐COVID patients during the COVID‐19 pandemic

Tucker

Ruszkay

Goyal

et al. 2022

Laryngoscope Investig Oto

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Objective(s) To analyze changes in tracheotomy practices at the onset of the COVID‐19 pandemic, and determine if quality patient care was maintained. Methods This was a single institution retrospective study that included patients undergoing tracheotomy from May 2019 to January 2021. Patients were divided into two groups, pre‐COVID and post‐COVID. Only three patients tested positive for COVID‐19, and they were excluded from the study. Data were collected from the electronic medical record. Statistical analyses were performed using 2‐tailed independent t tests, Wilcoxon Rank Sum tests, Chi‐Square tests, and Kaplan–Meier curves. Results There were 118 patients in the pre‐COVID group and 91 patients in the post‐COVID group. The main indication for tracheotomy in both groups was prolonged intubation. There were no significant differences in overall length of stay, time to tracheotomy, duration of tracheotomy procedure, or time to initial tracheotomy change between the two groups. Due to protocols implemented at our institution to limit viral transmission, there were significant increases in the percent of tracheotomies performed in the OR ( p = .02), and those performed via open technique ( p = .04). Additionally, the median time to decannulation significantly decreased in the post‐COVID group ( p = .02). Conclusion Several variables regarding the timing of patient care showed no significant differences between groups which demonstrates that quality patient care was maintained. It is important to note that this data was collected early in the Pandemic, and additional trends may become apparent over time. Level of evidence 4.

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Optimizing Airway Surgery in COVID 19 Era

Cited by 6 publications

References 35 publications

Revisiting Tonsillectomy Practices in the Light of the COVID-19 Pandemic

Revisiting Tonsillectomy Practices in the Light of the COVID-19 Pandemic

Thyroid surgery during the COVID-19 pandemic: results from a systematic review

Quality tracheotomy care can be maintained for non‐COVID patients during the COVID‐19 pandemic

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