American journal of otolaryngology
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The COVID-19 pandemic has led to concerns over transmission risk from healthcare procedures, especially when operating in the head and neck such as during surgical repair of facial fractures. This study aims to quantify aerosol and droplet generation from mandibular and midface open fixation and measure mitigation of airborne particles by a smoke evacuating electrocautery hand piece. ⋯ Risk from visible droplets during mandible and midface fixation is low. However, significant increases in aerosolized particles were measured after electrocautery use and during powered drilling. Aerosol dispersion is significantly decreased with the use of a smoke evacuating electrocautery hand piece.
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With the current COVID-19 outbreak, otolaryngologists are most exposed to the risk of infection due to the nature of the specialty.This is why they are required to find safer diagnostic alternatives minimizing aerosol-generating procedures. The aim of this study is to explore the accuracy of transcutaneous laryngeal ultrasonography (TLUSG) in order to assess vocal fold movement. ⋯ Although TLUSG could undoubtedly not replace laringoscopy, it represents a noninvasive and useful diagnostic tool for otolaryngologists especially during covid-19 pandemic.Data collected about its high sensitivity and specificity suggest that TLUSG could be a reliable method to screen vocal fold paralysis without performing aerosol-generating procedures, thus providing clear visualization of laryngeal real-time movements, even in non-compliant or high-risk infection patients. Our results allow us to consider TLUSG as part of the preoperative assessment of vocal folds in patients undergoing thyroidectomy.
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To assess trends of Google Search queries for symptoms and complaints encountered commonly in otolaryngology practices during the coronavirus disease 2019 (COVID-19) pandemic when in-person care has been limited. ⋯ This study demonstrates that Google search activity for many otolaryngology-related terms during the COVID-19 pandemic has increased or decreased significantly as compared to previous years. With reduced access to in-office otolaryngology care in the United States during the COVID-19 pandemic, these are important considerations for otolaryngology practices to meet the needs of patients who lack access to care.
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During patient transport from operating room to post-operative recovery area, anesthesia staff are at increased risk of particle aerosolization from patients despite wearing face shields. Current single-use face shields do not provide anesthesia staff from adequate protection from bioaerosolized particles expired during a patient's cough, particularly during transfer from the operating room to the post-anesthesia recovery unit. In this study, we compare the efficacy of single-use face shield currently available at our institution to a newly designed face shield that provides better protection while still maintaining cost-effectiveness and the ease-of-use of a disposable device. ⋯ Transfer from the operating room to the post-operative recovery unit is a hands-on process and involves managing multiple aspects of patient care physically. Current single-use face shields are convenient and cost-effective, but do not provide adequate protection from droplet aerosolization by patients during transfer. Other masks that provide adequate coverage are costly and are not designed to be single-use. A single-use disposable face shield that offers improved coverage of the lower face provides improved protection for anesthesia staff while maintaining cost-effectiveness, ease-of-use, and infection control.
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Describe current practices and challenges in personal protective equipment (PPE) use among US otolaryngologists during the COVID-19 pandemic. ⋯ The majority of participants reported routine access to full PPE for AGPs and pAGPs in all patients, regardless of COVID status. There was a high perception of security, as well as adequate N95 fitting and PPE training. Areas for improvement include: optimizing PPE availability for AGPs in patients without confirmed COVID and wider recognition of otolaryngologic procedures as high risk for aerosolization.