The use of acrylic window as protective physical barrier against coronavirus infection in the context of voice disorders

Self-care and clinical management of persons with laryngectomy during COVID-19 pandemic: a narrative review

“…[ 9 , 15 , 16 ] Initial screening and triaging • Use telerehabilitation whenever possible [ 5 , 13 ] especially for screening purposes. However, also remember that alaryngeal speech may pose a communication barrier in telemedicine [ 21 ] • Compare the urgency and seriousness of the issue against risk of hospital visit before asking the patient to visit the hospital [ 21 ] • Patients must be advised self- management of leakage-related issues at home whenever possible or until hospital visit [ 16 , 18 ] Recommendations to manage prothesis-related leakage at home • Using thickeners for liquids [ 13 , 15 , 17 , 18 , 20 ] • Use of plug in their voice prosthesis [ 13 , 17 , 20 ] or catheter until hospital visit [ 18 ] • Cleaning prosthesis to ensure valve is proper, cyclic intake of solid and liquid food [ 13 ] • Temporarily using the inserter stick as a plug, using cotton tipped applicators to absorb droplets from the sides of the value opening [ 13 ] • In case the TE speech fails, AACs and artificial larynx is recommended [ 20 ] Direct consultation • Delay in the management of leakage-related issues may cause aspiration and breathing difficulties [ 21 ]; therefore, hospital visit is unavoidable or cannot be prolonged for long in certain cases • COVID Testing of the patient (both nasal and tracheal swab) to be done before direct trouble shooting of TE related issues [ 5 ] • Use of physical barrier such as to create isolated space for physical examination of patient can be used if possible [ 26 ] • Use of lidocaine spray to prevent cough [ 9 ] Telerehabilitation • Telemedicine facilitates access to care [ 21 ]; can be used for management of patients as well as surveillance [ 20 ] especially those using TE speech [ …”

“…• Use of physical barrier such as to create isolated space for physical examination of patient can be used if possible [ 26 ]…”

“…Therefore, these procedures must be done in isolated rooms with strict adherence to the hospital protocol for disinfecting the room before seeing the next patient. Use of innovative strategies such as glass or acrylic barriers is cost-effective option that can help preserve PPEs [ 26 ]. However, the efficacy of such modifications needs exploration.…”

“…The studies included in the review were compiled in order to present a comprehensive view of the global scenario in managing persons with laryngectomy during the COVID-19 pandemic. Majority of the articles included in the review were commentaries [ 5 , 6 , 10 , 13 , 21 ], editorials [9,12,,14,18], and letters to the editor [ 19 , 26 ]. Others were case reports [ 22 – 25 ] or review articles [ 15 – 17 , 27 ].…”

An International Commentary on Dysphagia and Dysphonia During the COVID-19 Pandemic

“…The ‘Bubble PAPR PPE hood’ is in development by the UK National Tracheostomy Safety Project [ 36 ] and another recent early-stage innovation report describes the development of a transparent-modified full-face snorkel mask [ 37 ]. Air filtration systems and acrylic windows have been utilized to allow VFSS and FEES to proceed with reduced transmission risk and with better efficiency due to the reduced air exchange time required for rooms to be ventilated between patients [ 38 – 41 ]. The SNAP (Safe Nasoendoscopic Airway Procedure) device, developed by ENT surgeons in the UK, is a single-use valved endoscopic port retrofitted to any surgical mask permitting entry of a flexible endoscope, while limiting viral spread from the nasopharynx.…”