Ventilated Upper Airway Endoscopic Endonasal Procedure Mask: Surgical Safety in the COVID-19 Era.
Oper Neurosurg (Hagerstown)
; 19(3): 271-280, 2020 09 01.
Article
in En
| MEDLINE
| ID: mdl-32472685
ABSTRACT
BACKGROUND:
COVID-19 poses a risk to the endoscopic skull base surgeon. Significant efforts to improving safety have been employed, including the use of personal protective equipment, preoperative COVID-19 testing, and recently the use of a modified surgical mask barrier.OBJECTIVE:
To reduce the risks of pathogen transmission during endoscopic skull base surgery.METHODS:
This study was exempt from Institutional Review Board approval. Our study utilizes a 3-dimensional (3D)-printed mask with an anterior aperture fitted with a surgical glove with ports designed to allow for surgical instrumentation and side ports to accommodate suction ventilation and an endotracheal tube. As an alternative, a modified laparoscopic surgery trocar served as a port for instruments, and, on the contralateral side, rubber tubing was used over the endoscrub endosheath to create an airtight seal. Surgical freedom and aerosolization were tested in both modalities.RESULTS:
The ventilated mask allowed for excellent surgical maneuverability and freedom. The trocar system was effective for posterior surgical procedures, allowing access to critical paramedian structures, and afforded a superior surgical seal, but was limited in terms of visualization and maneuverability during anterior approaches. Aerosolization was reduced using both the mask and nasal trocar.CONCLUSION:
The ventilated upper airway endoscopic procedure mask allows for a sealed surgical barrier during endoscopic skull base surgery and may play a critical role in advancing skull base surgery in the COVID-19 era. The nasal trocar may be a useful alternative in instances where 3D printing is not available. Additional studies are needed to validate these preliminary findings.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Coronavirus Infections
/
Neuroendoscopy
/
Pandemics
/
Personal Protective Equipment
/
Betacoronavirus
/
Masks
/
Nasal Cavity
Limits:
Humans
Language:
En
Journal:
Oper Neurosurg (Hagerstown)
Year:
2020
Document type:
Article
Affiliation country:
Georgia