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1.
Vestn Otorinolaringol ; 85(4): 89-92, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32885645

RESUMO

Within the framework of the III All-Russian scientific and practical conference of otorhinolaryngologists, audiologists, somnologists and maxillofacial surgeons with international participation, a meeting of experts in the field of ENT diseases was held with the support of Heel RUS LLC, October 17-18, 2019, Kazan.


Assuntos
Otorrinolaringopatias , Audiologistas , Humanos , Federação Russa
2.
Eur Ann Otorhinolaryngol Head Neck Dis ; 137(4): 257-261, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32624390

RESUMO

AIMS: To assess the benefit of telemedicine consultation during the Covid-19 pandemic. MATERIAL AND METHODS: A prospective study of patient satisfaction with telemedicine consultation was carried out in the ENT department of a university hospital center where telemedicine consultations were set up to replace scheduled out-patient consultations. Patients were divided into two groups according to overall satisfaction, in order to identify predictive factors. The significance threshold was set at P<0.005. The main endpoint was patient satisfaction after an ENT telemedicine consultation during global lockdown. The secondary endpoint comprised predictive factors for overall satisfaction. RESULTS: One hundred of the 125 patients with telemedicine consultation over a 7-day inclusion period completed the questionnaire. Overall satisfaction was 87%. There were no clinically relevant predictive factors significantly associated with satisfaction. Sound and video quality was satisfactory for 76% and 61% of patients respectively, without significant impact on overall satisfaction (respectively: OR=3.40, P-value=0.049; and OR=3.79, P-value=0.049). Lack of physical examination did not significantly correlate with reduced overall satisfaction (OR=0.30, P-value=0.027). CONCLUSION: Telemedicine consultation did not allow complete medical care but, in a difficult time like the global pandemic, was well accepted by patients. It is a simple way to maintain continuity of care while reducing contamination risk by avoiding direct contact between patients and healthcare professionals.


Assuntos
Infecções por Coronavirus , Otorrinolaringopatias/terapia , Pandemias , Satisfação do Paciente , Pneumonia Viral , Qualidade da Assistência à Saúde , Telemedicina , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autorrelato , Adulto Jovem
3.
Eur Ann Otorhinolaryngol Head Neck Dis ; 137(4): 251-256, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32712116

RESUMO

OBJECTIVE: To analyze the impact of the first month of lockdown related to the 2020 SARS-Cov-2 epidemic on the consulting activity of private ENT physicians in Réunion Island. MATERIAL AND METHODS: A multicenter prospective study analyzed the consulting activity of 12 ENT physicians in full-time private practice. The main endpoints were the number, characteristics and conditions of consultations. Secondary endpoints comprised presenting symptoms, diagnosis, prescriptions, adverse effects, and progression of monthly consulting turnover. RESULTS: Six hundred and ninety three consultations were performed during the study period (Appendix 1), with 50% emergency consultations. In 57.9% were face-to-face, 28.4% by phone and 13.7% video. In face-to-face consultation, the physician wore gloves in 53.8% of cases and a mask in 92.2%: surgical mask in 71.6% of cases and FFP2 in 28.4%. The three most frequent symptoms (48.5% of cases) were otalgia, hearing impairment, and vertigo. The three most frequent diagnoses (60.6% of cases) were otitis, intra-auricular foreign body (including wax), and pharyngeal infection. The three most frequently prescribed complementary exams (74.3% of cases) were imaging, hearing work-up, and specialist opinion. The three most frequently prescribed treatments (52.7% of cases) were intra-auricular drops, oral antibiotics, and nasal spray. The incidence of adverse effects was 0.001%. None of the physicians or patients seemed to have been infected by Covid-19 during the study period. There was a 47.3-91% (median, 75.6%) drop in monthly consultation turnover. CONCLUSION: The present study underscored the availability and adaptability of ENT physicians in the Réunion Island in an epidemic context, although economic impact was detrimental.


Assuntos
Infecções por Coronavirus/epidemiologia , Otolaringologia , Otorrinolaringopatias , Pneumonia Viral/epidemiologia , Prática Privada/estatística & dados numéricos , Quarentena/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Otorrinolaringopatias/diagnóstico , Otorrinolaringopatias/terapia , Pandemias , Estudos Prospectivos , Reunião , Fatores de Tempo
4.
J Otolaryngol Head Neck Surg ; 49(1): 36, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: covidwho-505665

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and surgeries are Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers of becoming infected with SARS-CoV-2 while providing clinical care. RECOMMENDATIONS: During the COVID-19 pandemic all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. For non-AGMPs in all patients, even COVID-19 positive patients Level 1 PPE (surgical mask, gown, gloves and face shield or goggles) is sufficient. If local prevalence is favourable and patients are asymptomatic and test negative for SARS-CoV-2, Level 1 PPE can be used during short duration AGMPs, with limited risk of infected aerosol spread. For AGMPs in patients who test positive for SARS-CoV-2 a minimum of Level 2 PPE, with adequate protection of mucosal surfaces, is recommended (N95/FFP2 respirator, gown, double gloves, goggles or face shield and head cover). For long duration AGMPs that are deemed high-risk in COVID-19 positive patients, Level 3 PPE can provide a higher level of protection and be more comfortable during long duration surgeries if surgical hoods or PAPRs are used. It is recommended that these procedures are performed in negative pressure rooms, if available. It is essential to follow strict donning and doffing protocols to minimize the risk of contamination. CONCLUSIONS: By following strict infection prevention recommendations, the risk of HCWs becoming infected with SARS-CoV-2 while treating patients can be minimized. As the COVID-19 pandemic evolves rapidly, these recommendations should serve as guidance and need to be interpreted based on local factors and availability of healthcare resources.


Assuntos
Infecções por Coronavirus/transmissão , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Otolaringologia/normas , Otorrinolaringopatias/terapia , Procedimentos Cirúrgicos Otorrinolaringológicos/normas , Pneumonia Viral/transmissão , Aerossóis/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/normas , Humanos , Otolaringologia/organização & administração , Otorrinolaringopatias/diagnóstico , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Equipamentos de Proteção/normas
5.
Vestn Otorinolaringol ; 85(2): 63-66, 2020.
Artigo em Russo | MEDLINE | ID: covidwho-497964

RESUMO

Recently, almost all over the world attention of doctors and scientists is focused on a new coronavirus infection, the source of which was the causative agent SARS-CoV-2. In this regard, early diagnosis, including on the basis of symptoms from ENT organs, is crucial. A brief analysis of the available literature on the peculiarities of ENT organs manifestations in patients with SARS-CoV-2 is given. It was found out that to date there is very little data on the state of loro organs in patients with SARS-CoV-2 and no data on anosmia in the pediatric population. However, it is in children in the epidemic aspect that early diagnosis of infection and understanding of its key symptoms is of utmost importance.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Otorrinolaringopatias , Pandemias , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Criança , Infecções por Coronavirus/complicações , Diagnóstico Precoce , Humanos , Otorrinolaringopatias/etiologia , Pneumonia Viral/complicações
6.
Auris Nasus Larynx ; 47(4): 559-564, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32586739

RESUMO

OBJECTIVE: to detect, analyze and discuss the different ear nose throat (ENT) manifestations those were reported in COVID19 positive patients in the reviewed and published literatures. METHODS: We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords; COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, ear, nose, throat, otorhinolaryngology, ORL, pharynx, ORL, smell, larynx, different ENT related symptoms. We reviewed published and peer reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. RESULTS: within the included 1773 COVID-19 laboratory-confirmed positive patients, the most common ENT manifestations of COVID-19 were sore throat (11.3%) and headache (10.7%). While the other reported ENT manifestations were pharyngeal erythema (5.3%), nasal congestion (4.1%), runny nose or rhinorrhea (2.1%), upper respiratory tract infection (URTI) (1.9%), and tonsil enlargement (1.3%). CONCLUSION: ENT manifestations for COVID-19 are not common as fever and cough. But, a universal questionnaire using well-defined COVID-19 manifestations is needed to make the COVID-19 data precisely defined, complete and homogenous.


Assuntos
Infecções por Coronavirus/fisiopatologia , Transtornos do Olfato/fisiopatologia , Faringite/fisiopatologia , Pneumonia Viral/fisiopatologia , Tonsila Faríngea , Betacoronavirus , Tosse/fisiopatologia , Diarreia/fisiopatologia , Dispneia/fisiopatologia , Eritema/fisiopatologia , Fadiga/fisiopatologia , Febre/fisiopatologia , Cefaleia/fisiopatologia , Humanos , Mialgia/fisiopatologia , Obstrução Nasal/fisiopatologia , Otorrinolaringopatias/fisiopatologia , Tonsila Palatina , Pandemias , Infecções Respiratórias/fisiopatologia
7.
Eur Ann Otorhinolaryngol Head Neck Dis ; 137(4): 315-317, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32482571

RESUMO

This consensus statement about the indications and modalities of corticosteroid treatment in the context of the COVID-19 pandemic was jointly written by experts from the French Association of Otology and Oto-Neurology (AFON) and from the French Society of Otorhinolaryngology, Head and Neck Surgery (SFORL). There is currently not enough data in favour of danger or benefit from corticosteroids in COVID-19, so until this matter is resolved it is advisable to limit their indications to the most serious clinical pictures for which it is well established that this type of treatment has a positive impact on the progression of symptoms. In Grade V and VI Bell's palsy according to the House-Brackmann grading system, a week's course of oral corticosteroids is recommended. Corticosteroid therapy is also recommended in cases of sudden hearing loss of more than 60dB, either in the form of intratympanic injections or a week's course of oral medication. In rhinology, there is no indication for systemic corticosteroid therapy in the current situation. However, patients are advised to continue with their local corticosteroid therapy in the form of a nasal spray or by inhalation. Treatments with corticosteroid nasal sprays can still be prescribed if there is no alternative. Finally, systemic or local corticosteroid therapy is not indicated for bacterial ENT infections.


Assuntos
Corticosteroides/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Otorrinolaringopatias/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Infecções por Coronavirus/complicações , Humanos , Otorrinolaringopatias/virologia , Pandemias , Pneumonia Viral/complicações
8.
Head Neck ; 42(7): 1681-1689, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32476228

RESUMO

BACKGROUND: In light of the COVID-19 pandemic, there has been a rapid increase in telemedicine visits. Otolaryngology patient satisfaction with these visits has not yet been extensively studied using a validated survey. METHODS: All patients who had telemedicine visits with three head and neck surgeons, by phone or video-based platform, between March 25, 2020 and April 24, 2020. Retrospective chart reviews were conducted to determine demographic, disease, and treatment information. Patients who had a video visit were contacted by telephone and, if they could be reached and consented, were administered the telehealth usability questionnaire (TUQ). RESULTS: Hundred surveys were completed. The average score across all questions was 6.01 on a scale from 1 to 7, where 7 indicated the highest level of patient agreement. The highest scores were for questions related to satisfaction with telehealth (6.29), while the lowest were related to reliability (4.86). CONCLUSIONS: Patients are generally highly satisfied with telemedicine.


Assuntos
Assistência Ambulatorial , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Otorrinolaringopatias/epidemiologia , Satisfação do Paciente , Pneumonia Viral/epidemiologia , Telemedicina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pennsylvania/epidemiologia , Estudos Retrospectivos , Inquéritos e Questionários
9.
Head Neck ; 42(7): 1610-1620, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32510716

RESUMO

BACKGROUND: Italy was the first European country suffering from COVID-19. Health care resources were redirected to manage the pandemic. We present our initial experience with the management of urgent and nondeferrable surgeries for sinus and skull base diseases during the COVID-19 pandemic. METHODS: A retrospective review of patients treated in a single referral center during the first 2 months of the pandemic was performed. A comparison between the last 2-month period and the same period of the previous year was carried out. RESULTS: Twenty-four patients fulfilled the inclusion criteria. A reduction of surgical activity was observed (-60.7%). A statistically significant difference in pathologies treated was found (P = .016), with malignancies being the most frequent indication for surgery (45.8%). CONCLUSIONS: Although we feel optimistic for the future, we do not feel it is already time to restart elective surgeries. Our experience may serve for other centers who are facing the same challenges.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Otorrinolaringopatias/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Controle de Infecções , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias , Pneumonia Viral/diagnóstico , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto Jovem
10.
Otolaryngol Head Neck Surg ; 163(2): 307-315, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32482131

RESUMO

OBJECTIVE: Limited research exists on the coronavirus disease 2019 (COVID-19) pandemic pertaining to otolaryngology-head and neck surgery (OHNS). The present study seeks to understand the response of OHNS workflows in the context of policy changes and to contribute to developing preparatory guidelines for perioperative management in OHNS. STUDY DESIGN: Retrospective cohort study. SETTING: Pediatric and general adult academic medical centers and a Comprehensive Cancer Center (CCC). SUBJECTS AND METHODS: OHNS cases from March 18 to April 8, 2020-the 3 weeks immediately following the Ohio state-mandated suspension of all elective surgery on March 18, 2020-were compared with a 2019 control data set. RESULTS: During this time, OHNS at the general adult and pediatric medical centers and CCC experienced 87.8%, 77.1%, and 32% decreases in surgical procedures as compared with 2019, respectively. Aerosol-generating procedures accounted for 86.8% of general adult cases, 92.4% of pediatric cases, and 62.0% of CCC cases. Preoperative COVID-19 testing occurred in 7.1% of general adult, 9% of pediatric, and 6.9% of CCC cases. The majority of procedures were tiers 3a and 3b per the Centers for Medicare & Medicaid Services. Aerosol-protective personal protective equipment (PPE) was worn in 28.6% of general adult, 90% of pediatric, and 15.5% of CCC cases. CONCLUSION: For OHNS, the majority of essential surgical cases remained high-risk aerosol-generating procedures. Preoperative COVID-19 testing and intraoperative PPE usage were initially inconsistent; systemwide guidelines were developed rapidly but lagged behind recommendations of the OHNS department and its academy. OHNS best practice standards are needed for preoperative COVID-19 status screening and PPE usage as we begin national reopening.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Otorrinolaringopatias/cirurgia , Pneumonia Viral/diagnóstico , Cuidados Pré-Operatórios/estatística & dados numéricos , Adulto , Aerossóis , Idoso , Criança , Pré-Escolar , Procedimentos Cirúrgicos Eletivos/legislação & jurisprudência , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Ohio , Otolaringologia , Pandemias , Guias de Prática Clínica como Assunto , Cuidados Pré-Operatórios/normas , Estudos Retrospectivos , Risco
11.
Int J Pediatr Otorhinolaryngol ; 136: 110169, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32526541

RESUMO

OBJECTIVES: To develop a workflow algorithm for physicians and staff to decrease cross contamination and minimize exposure to Coronavirus Disease -19 (COVID-19) in pediatric otolaryngology at a community pediatric hospital. METHODS: PubMed and Google Scholar searches were carried out using the keywords. Pertinent clinical information related to pediatric otolaryngology was reviewed from journals, Texas Medical Board guidelines as well as institutional guidelines. Updated information from the Centers for Disease Control through social media was identified via Google search. STUDY DESIGN: Safety measures and clinical work-flow protocols were developed to protect patients, families, and staff. Protocols included a rotation schedule for providers and ancillary staff, guidelines for in-clinic visits and alteration to surgical block and surgical case cadence to minimize exposure of providers and staff to COVID-19. Algorithms and guidelines were reviewed and revisions made at each phase of the pandemic related to in-clinic visits, telemedicine visits, and surgical cases. CONCLUSION: In the era of the COVID-19 pandemic, otolaryngologists and pediatric otolaryngologists are amongst sub-specialties with an increased risk of exposure. It is imperative that a modification in clinical workflow is created to minimize the risk of exposure to providers and staff while continuing to provide care to patients. PRACTICE IMPLICATIONS: The COVID-19 pandemic continues to evolve and change rapidly. The described guidelines and workflow algorithm serve as tools to help pediatric otolaryngologists protect themselves and their staff and patients during this global crisis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Otorrinolaringopatias , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Criança , Infecções por Coronavirus/transmissão , Hospitais Comunitários , Hospitais Pediátricos , Humanos , Otolaringologia , Otorrinolaringopatias/terapia , Pneumonia Viral/transmissão , Telemedicina , Fluxo de Trabalho
12.
Vestn Otorinolaringol ; 85(2): 63-66, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32476394

RESUMO

Recently, almost all over the world attention of doctors and scientists is focused on a new coronavirus infection, the source of which was the causative agent SARS-CoV-2. In this regard, early diagnosis, including on the basis of symptoms from ENT organs, is crucial. A brief analysis of the available literature on the peculiarities of ENT organs manifestations in patients with SARS-CoV-2 is given. It was found out that to date there is very little data on the state of loro organs in patients with SARS-CoV-2 and no data on anosmia in the pediatric population. However, it is in children in the epidemic aspect that early diagnosis of infection and understanding of its key symptoms is of utmost importance.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Otorrinolaringopatias , Pandemias , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Criança , Infecções por Coronavirus/complicações , Diagnóstico Precoce , Humanos , Otorrinolaringopatias/etiologia , Pneumonia Viral/complicações
13.
J Otolaryngol Head Neck Surg ; 49(1): 36, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493489

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and surgeries are Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers of becoming infected with SARS-CoV-2 while providing clinical care. RECOMMENDATIONS: During the COVID-19 pandemic all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. For non-AGMPs in all patients, even COVID-19 positive patients Level 1 PPE (surgical mask, gown, gloves and face shield or goggles) is sufficient. If local prevalence is favourable and patients are asymptomatic and test negative for SARS-CoV-2, Level 1 PPE can be used during short duration AGMPs, with limited risk of infected aerosol spread. For AGMPs in patients who test positive for SARS-CoV-2 a minimum of Level 2 PPE, with adequate protection of mucosal surfaces, is recommended (N95/FFP2 respirator, gown, double gloves, goggles or face shield and head cover). For long duration AGMPs that are deemed high-risk in COVID-19 positive patients, Level 3 PPE can provide a higher level of protection and be more comfortable during long duration surgeries if surgical hoods or PAPRs are used. It is recommended that these procedures are performed in negative pressure rooms, if available. It is essential to follow strict donning and doffing protocols to minimize the risk of contamination. CONCLUSIONS: By following strict infection prevention recommendations, the risk of HCWs becoming infected with SARS-CoV-2 while treating patients can be minimized. As the COVID-19 pandemic evolves rapidly, these recommendations should serve as guidance and need to be interpreted based on local factors and availability of healthcare resources.


Assuntos
Infecções por Coronavirus/transmissão , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Otolaringologia/normas , Otorrinolaringopatias/terapia , Procedimentos Cirúrgicos Otorrinolaringológicos/normas , Pneumonia Viral/transmissão , Aerossóis/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/normas , Humanos , Otolaringologia/organização & administração , Otorrinolaringopatias/diagnóstico , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Equipamentos de Proteção/normas
14.
J Otolaryngol Head Neck Surg ; 49(1): 28, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: covidwho-186661

RESUMO

BACKGROUND: Aerosol generating medical procedures (AGMPs) present risks to health care workers (HCW) due to airborne transmission of pathogens. During the COVID-19 pandemic, it is essential for HCWs to recognize which procedures are potentially aerosolizing so that appropriate infection prevention precautions can be taken. The aim of this literature review was to identify potential AGMPs in Otolaryngology - Head and Neck Surgery and provide evidence-based recommendations. METHODS: A literature search was performed on Medline, Embase and Cochrane Review databases up to April 3, 2020. All titles and abstracts of retrieved studies were evaluated and all studies mentioning potential AGMPs were included for formal review. Full text of included studies were assessed by two reviewers and the quality of the studies was evaluated. Ten categories of potential AGMPs were developed and recommendations were provided for each category. RESULTS: Direct evidence indicates that CO2 laser ablation, the use of high-speed rotating devices, electrocautery and endotracheal suctioning are AGMPs. Indirect evidence indicates that tracheostomy should be considered as potential AGMPs. Nasal endoscopy and nasal packing/epistaxis management can result in droplet transmission, but it is unknown if these procedures also carry the risk of airborne transmission. CONCLUSIONS: During the COVID-19 pandemic, special care should be taken when CO2 lasers, electrocautery and high-speed rotating devices are used in potentially infected tissue. Tracheal procedures like tracheostomy and endotracheal suctioning can also result in airborne transmission via small virus containing aerosols.


Assuntos
Aerossóis/efeitos adversos , Infecções por Coronavirus/transmissão , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Pneumonia Viral/transmissão , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/virologia , Humanos , Otorrinolaringopatias/complicações , Otorrinolaringopatias/cirurgia , Otorrinolaringopatias/virologia , Procedimentos Cirúrgicos Otorrinolaringológicos/instrumentação , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Pandemias , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto
15.
Otolaryngol Pol ; 74(3): 1-5, 2020 Jun 30.
Artigo em Inglês | MEDLINE | ID: covidwho-252801

RESUMO

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.


Assuntos
Anestesiologia/normas , Infecções por Coronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Infecções/normas , Otolaringologia/normas , Pandemias , Assistência ao Paciente/normas , Pneumonia Viral , Assistência Ambulatorial/normas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Hospitalização , Humanos , Otorrinolaringopatias/terapia , Procedimentos Cirúrgicos Otorrinolaringológicos/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Polônia
16.
Otolaryngol Head Neck Surg ; 163(1): 47-50, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32366174

RESUMO

The impact of the COVID-19 pandemic has been far-reaching and has profoundly affected the practice of otolaryngology in an unprecedented way. In this commentary, we draw from our experience in the first 90 days of the pandemic and discuss a set of workflow measures, personal protection equipment protocols, and strategic goals that can provide a safe environment for patients and staff to continue managing a significant proportion of patients in the otolaryngology service during the pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Transmissão de Doença Infecciosa/prevenção & controle , Otolaringologia/organização & administração , Otorrinolaringopatias/complicações , Pandemias , Pneumonia Viral/epidemiologia , Centros de Atenção Terciária , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Humanos , Otorrinolaringopatias/terapia , Pneumonia Viral/complicações , Pneumonia Viral/transmissão
17.
Otolaryngol Head Neck Surg ; 163(1): 54-59, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32369430

RESUMO

Academic otolaryngology has historically comprised a tripartite mission of research, education, and clinical care. This mission is greatly strained by the COVID-19 pandemic. Research laboratories are fallow, surgical cases are deferred, and clerkships are canceled. Otolaryngologists are adapting to new circumstances ranging from virtual patient care to urgent procedures in protective gear to deployment to provisional field hospitals. Amid these operational challenges, the specialty is demonstrating extraordinary resilience and grit, discovering new ways to serve learners, colleagues, and communities. Statements from leaders in otolaryngology reveal selfless acts and purposefulness. Necessity has spurred innovation in education, science, and novel models of care. Paragons strike notes of hope, inspiring us to persevere and serve. This commentary explores the present challenges and offers a vision for upholding the academic mission.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Modelos Organizacionais , Otolaringologia/organização & administração , Otorrinolaringopatias/terapia , Assistência ao Paciente/normas , Pneumonia Viral/complicações , Qualidade da Assistência à Saúde/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Otorrinolaringopatias/complicações , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
18.
Otolaryngol Head Neck Surg ; 163(1): 138-144, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32393101

RESUMO

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has induced a prioritization of acute care and telehealth, affecting the quantity of patients seen and the modality of their care. STUDY DESIGN: Retrospective review. SETTING: Single-institution study conducted within the Division of Otolaryngology at the Yale School of Medicine. SUBJECTS AND METHODS: Data on all outpatient appointments within the Division of Otolaryngology were obtained from administrative records of billing and scheduling from March 16 to April 10, 2020. For comparison, a corresponding period from 2019 was also utilized. RESULTS: Of 5913 scheduled visits, 3665 (62.0%) were seen between March 18 and April 12, 2019, in comparison with 649 of 5044 (12.9%) during the corresponding COVID-19-affected period. The majority of completed visits performed in weeks 1 and 2 were in person, while the majority in weeks 3 and 4 were via telehealth. Among subspecialties, a larger proportion of completed visits in 2020 were performed by pediatric and head and neck oncology otolaryngologists as compared with general/specialty otolaryngologists (P < .001). Older adults (≥65 years) were less likely to have telehealth visits than younger adults (18-64 years; 45.6% vs 59.6%, P = .003). CONCLUSIONS: A major decrease in the completion rates of scheduled visits was seen in the COVID-19-affected period, though this was not proportional among subspecialties. An associated increase in telehealth visits was observed. After COVID-19-related hospital policy changes, approximately 2 weeks passed before telehealth visits surpassed in-person visits, though this was not true among older adults.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Otorrinolaringologistas/normas , Otorrinolaringopatias/terapia , Pacientes Ambulatoriais , Pneumonia Viral/complicações , Padrões de Prática Médica , Telemedicina/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Análise de Dados , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otorrinolaringopatias/complicações , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
19.
Otolaryngol Head Neck Surg ; 163(1): 1-2, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32393147

RESUMO

In the wake of the tremendous fallout from the COVID-19 pandemic that was mostly negative, I find great optimism and encouragement from the ability of society at all levels to focus on a common problem with a collaborative and productive resolve to address this millennial event. The rapid response was made possible by marshaling the resources available from many sources, not the least of which was the medical association community. It has been particularly gratifying to work hand-in-hand with our specialty societies within and outside the otolaryngology family to produce educational and scientific information that is consistent and that has and will continue to affect policy favorably. The groups that enable these inspirational collaborative accomplishments through their dedication, innovation, and imagination are the practicing physicians who have given freely and generously of their time and talents to help the whole health care community provide the most up-to-date care possible.


Assuntos
Betacoronavirus , Relações Comunidade-Instituição , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Otolaringologia/organização & administração , Otorrinolaringopatias/terapia , Pandemias , Pneumonia Viral/epidemiologia , Consenso , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Humanos , Otorrinolaringopatias/complicações , Pneumonia Viral/complicações , Pneumonia Viral/transmissão
20.
Otolaryngol Head Neck Surg ; 163(1): 121-131, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32396445

RESUMO

Objective. To describe coronavirus disease 2019 (COVID-19) patient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ear, nose, and throat (ENT) departments in 4 Chinese hospitals during the COVID-19 pandemic. Study Design. Retrospective case series. Setting. Multicenter. Subjects and Methods. Twenty hospitalized COVID-19 patients requiring ENT consultation from 3 designated COVID-19 hospitals in Wuhan, Shanghai, and Shenzhen were identified. Data on demographics, comorbidities, COVID-19 symptoms and severity, consult reason, treatment, and personal protective equipment (PPE) use were collected and analyzed. Infection control strategies implemented for ENT outpatients and emergency room visits at the Eye and ENT Hospital of Fudan University were reported. Results. Median age was 63 years, 55% were male, and 95% were in severe or critical condition. Six tracheotomies were performed. Posttracheotomy outcomes were mixed (2 deaths, 2 patients comatose, all living patients still hospitalized). Other consults included epistaxis, pharyngitis, nasal congestion, hyposmia, rhinitis, otitis externa, dizziness, and tinnitus. At all hospitals, powered air-supply filter respirators (PAPRs) were used for tracheotomy or bleeding control. PAPR or N95-equivalent masks plus full protective clothing were used for other complaints. No inpatient ENT providers were infected. After implementation of infection control strategies for outpatient clinics, emergency visits, and surgeries, no providers were infected at the Eye and ENT Hospital of Fudan University. Conclusions and Relevance. COVID-19 patients require ENT consultation for many reasons, including tracheotomy. Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection of otolaryngologists.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Otolaringologia/normas , Otorrinolaringopatias/terapia , Pandemias , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Adulto , Idoso , China/epidemiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otorrinolaringopatias/complicações , Pneumonia Viral/complicações , Pneumonia Viral/transmissão , Estudos Retrospectivos
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