Barrier device prototype for open tracheotomy during COVID-19 pandemic.

OBJECTIVE: To present a low-cost prototype for a barrier enclosure device which can be used during open surgeries such as tracheotomy. METHODS: We provide detailed description of a novel device called COVID-Box, developed by The Surgical Airway Team for COVID-19 Pandemic, a temporary task force formed by Walter Cantídio University Hospital. Safety guidelines for performing tracheotomies in COVID-19 patients are also stated. RESULTS: Our prototype device provides greater hand mobility than previous barrier devices reported, making it more suitable for airway surgical procedures, such as tracheotomy. The curved shaped format and the customizable access ports provides ergonomics, without compromising safety. CONCLUSION: The COVID-Box appears to be an efficient, reproduceable, low-cost barrier enclosure device that can be used for open tracheotomies in ICU patients during the COVID-19 pandemic.

Nasoangiofibroma juvenil: ressecção endoscópica / Juvenile nasopharyngeal angiofibroma: endoscopic resection

Introdução: O nasoangiofibroma juvenil (NAJ) é um tumor benigno, raro, cujo diagnóstico é baseado na tríade de epistaxe, obstrução nasal e presença de tumor na nasofaringe, associado a exames de imagem. O tratamento de escolha é a ressecção cirúrgica, podendo ser realizada por via aberta e/ou endoscópica. Objetivo: Apresentar série de casos de pacientes submetidos a tratamento cirúrgico por via endoscópica. Método: Estudo retrospectivo com revisão em prontuários de três pacientes submetidos à ressecção de NAJ por via endoscópica exclusiva. Resultados: Os três pacientes eram do sexo masculino com idades de 13, 25 e 31 anos. Foi realizada remoção completa do tumor em todos os casos. Um paciente evoluiu com lesão parcial de nervo óptico. Conclusão: A ressecção de NAJ por via endoscópica é possível, inclusive em casos com invasão intracraniana. Entretanto um profundo conhecimento da anatomia, além de instrumental específico é fundamental para a realização de cirurgias seguras e efetivas.

Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a benign and rare tumor. Diagnosis is based on the triad of epistaxis, unilateral nasal obstruction and presence of nasopharyngeal tumor associated with imaging studies. The treatment of choice is the surgical resection. It can be performed by open method and/or endoscopically. Objective: To present a case series of endoscopic surgical treatment of JNA. Method: A retrospective study reviewing the medical records of three patients who underwent exclusively endoscopic resection of JNA. Results: The three patients were males aged 13, 25 and 31 years. A complete resection was performed in all cases. One patient had a partial lesion of the optic nerve. Conclusion: The exclusively endoscopic resection of JNA is possible, even in cases with intracranial invasion. However, a solid knowledge of anatomy and specific instruments are essential to achieve safe and effective surgery.