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1501. Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic. Full Text available with Trip Pro

Repurposing 0.5% povidone iodine solution in otorhinolaryngology practice in Covid 19 pandemic. SARS CoV 2 is very much homologous in structure to SARS CoV. Review of literature suggests the in-vitro virucidal action of povidone iodine in SARS CoV and MERS. The oropharynx and nasopharynx are target sites of SARS CoV 2. A significant proportion of COVID 19 sufferers are asymptomatic, but shedding these viral particles, PVP-I has been shown to be a safe therapy when used as a mouthwash or taken

2020 American Journal of Otolaryngology

1502. Symptomatology in head and neck district in coronavirus disease (COVID-19): A possible neuroinvasive action of SARS-CoV-2. Full Text available with Trip Pro

Symptomatology in head and neck district in coronavirus disease (COVID-19): A possible neuroinvasive action of SARS-CoV-2. The aim of this manuscript is to investigate transversally Ear Nose Throat (ENT) symptoms COVID-19 infection correlated and to study the neurotropism and neuroinvasiveness of the virus in the head-neck district through the investigation of the sense of smell, taste, tearing, salivation and hearing.A total of 50 patients with laboratory-confirmed COVID-19 infection were (...) included in our study. For each patient we evaluated the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS), the Summated Xerostomia Inventory-Dutch Version (SXI-DV), The Standardized Patient Evaluation of Eye Dryness (SPEED), Schirmer test I, the Hearing Handicap Inventory For Adults (HHIA) and the Tinnitus Handicap Inventory (THI). All the tests we carried out were performed during the active phase of the symptomatology from COVID-19 (Condition A) and 15 after

2020 American Journal of Otolaryngology

1503. Virtual scribing within otolaryngology during the COVID-19 pandemic and beyond. Full Text available with Trip Pro

Virtual scribing within otolaryngology during the COVID-19 pandemic and beyond. Within otolaryngology, scribes have been utilized as a means of increasing clinic efficiency and easing workload on physicians. During the COVID-19 pandemic, a majority of otolaryngology clinic appointments at academic institutions have been moved to telemedicine in order to limit interpersonal contacts. At the height of the pandemic, our institution has protocolized scribe participation from in-person to remote

2020 American Journal of Otolaryngology

1504. Rapid implementation of COVID-19 tracheostomy simulation training to increase surgeon safety and confidence. Full Text available with Trip Pro

Rapid implementation of COVID-19 tracheostomy simulation training to increase surgeon safety and confidence. To determine if rapid implementation of simulation training for anticipated COVID-19 tracheostomy procedures can increase physician confidence regarding procedure competency and use of enhanced personal protective equipment (PPE).A brief simulation training exercise was designed in conjunction with the development of a COVID-19 Tracheostomy Protocol. The simulation training focused (...) in physician confidence regarding the safe performance of tracheostomy surgery in COVID-19 patients.Adoption of standardized COVID-19 tracheostomy simulation training at centers treating COVID-19 patients may result in improved physician safety and enhanced confidence in anticipation of performing these procedures in real-life scenarios.Copyright © 2020 Elsevier Inc. All rights reserved.

2020 American Journal of Otolaryngology

1505. Tracheostomy in the intensive care unit: Guidelines during COVID-19 worldwide pandemic. Full Text available with Trip Pro

Tracheostomy in the intensive care unit: Guidelines during COVID-19 worldwide pandemic. COVID-19 has become a pandemic with significant consequences worldwide. About 3.2% of patients with COVID-19 will require intubation and invasive ventilation. Moreover, there will be an increase in the number of critically ill patients, hospitalized and intubated due to unrelated acute pathology, who will present underlying asymptomatic or mild forms of COVID-19. Tracheostomy is one of the procedures (...) associated with an increased production of aerosols and higher risk of transmission of the virus to the health personnel. The aim of this paper is to describe indications and recommended technique of tracheostomy in COVID-19 patients, emphasizing the safety of the patient but also the medical team involved.A multidisciplinary group made up of surgeons with privileges to perform tracheostomies, intensive care physicians, infectious diseases specialists and intensive pulmonologists was created to update

2020 American Journal of Otolaryngology

1506. Preferential use of total intravenous anesthesia in ambulatory otolaryngology surgery during the COVID-19 pandemic. Full Text available with Trip Pro

Preferential use of total intravenous anesthesia in ambulatory otolaryngology surgery during the COVID-19 pandemic. The novel coronavirus (SARS-CoV-2 or COVID-19) pandemic has impacted nearly every aspect of otolaryngologic practice. The transition from office-based evaluation to telemedicine and the number of postponed elective surgical cases is unprecedented. There is a significant need to resume elective surgical care for these patients at the appropriate time. As practices begin to move

2020 American Journal of Otolaryngology

1507. Emergent procedures for oropharyngeal bleeding during the COVID-19 pandemic: Protection of medical staff. Full Text available with Trip Pro

Emergent procedures for oropharyngeal bleeding during the COVID-19 pandemic: Protection of medical staff. During an ongoing pandemic of COVID-19, controlling the oropharyngeal bleeding, such as post-tonsillectomy hemorrhage, with cauterization is considered a very vulnerable procedure for medical staff because of high probability of exposure to aerosolized secretion. The authors aimed to introduce an appropriate treatment protocol for oropharyngeal bleeding that provides first aid to patients (...) while protecting medical staff at high-risk of infection such as COVID-19.Copyright © 2020 Elsevier Inc. All rights reserved.

2020 American Journal of Otolaryngology

1508. 3D-printable headlight face shield adapter. Personal protective equipment in the COVID-19 era. Full Text available with Trip Pro

3D-printable headlight face shield adapter. Personal protective equipment in the COVID-19 era. The coronavirus SARS-CoV-2 (COVID19) pandemic has pushed health workers to find creative solutions to a global shortage of personal protection equipment (PPE). 3D-printing technology is having an essential role during the pandemic providing solutions for this problem, for instance, modifying full-face snorkel masks or creating low-cost face shields to use as PPE (Ishack and Lipner, 2020 [1

2020 American Journal of Otolaryngology

1509. Early experience in tracheostomy and tracheostomy tube management in Covid-19 patients. Full Text available with Trip Pro

Early experience in tracheostomy and tracheostomy tube management in Covid-19 patients. In Italy, we have experienced Europe's first and largest coronavirus outbreak. Based on our preliminary experience, we discuss the challenges in performing tracheotomy and tracheostoma care in the setting of a new pathogen.Copyright © 2020 Elsevier Inc. All rights reserved.

2020 American Journal of Otolaryngology

1510. Safe tracheotomy for patients with COVID-19. Full Text available with Trip Pro

Safe tracheotomy for patients with COVID-19. Patients affected by severe acute respiratory syndrome coronavirus 2 disease (COVID-19) with respiratory distress may need invasive mechanical ventilation for a long period of time. Head and neck surgeons are becoming increasingly involved in the care of COVID-19 patients because of the rapidly increasing number of tracheotomies required. This procedure, when performed without protection, may lead to the infection of the medical and nursing staff (...) caring for the patient. The aim of this report is to share our protocol for performing a safe surgical tracheotomy in COVID-19 patients. Infection of the nursing/medical staff involved in the first 30 tracheotomies performed in patients affected by COVID-19 in the Intensive Care Unit of a tertiary referral center were evaluated. Mistakes that occurred during surgery were analyzed and discussed. None of the nursing/medical staff presented signs or symptoms of COVID-19 within 15 days after

2020 American Journal of Otolaryngology

1511. "Hot Zones" for Otolaryngologists: Assessing the geographic distribution of aerosol-generating procedures amidst the COVID-19 pandemic. Full Text available with Trip Pro

"Hot Zones" for Otolaryngologists: Assessing the geographic distribution of aerosol-generating procedures amidst the COVID-19 pandemic. Given high COVID-19 viral load and aerosolization in the head and neck, otolaryngologists are subject to uniquely elevated viral exposure in most of their inpatient and outpatient procedures and interventions. While elective activity has halted across the board nationally, the slow plateau of COVID-19 case rates prompts the question of timing of resumption (...) of clinical activity. We sought to prospectively predict geographical "hot zones" for otolaryngological exposure to COVID-19 based on procedural volumes data from 2013 to 2017.Otolaryngologic CPT codes were stratified based on risk-level, according to recently published specialty-specific guidelines. Using the Medicare POSPUF database, aerosol-generating procedures (AGPs) were mapped based on hospital referral regions, against up-to-date COVID-19 case distribution data, as of April 24, 2020.The most

2020 American Journal of Otolaryngology

1512. Nasopharyngeal swab collection in the suspicion of Covid-19. Full Text available with Trip Pro

Nasopharyngeal swab collection in the suspicion of Covid-19. RT-PCR detection of SARS-CoV-2 mRNA on nasopharyngeal swab is the standard for diagnosing active Covid-19 disease in asymptomatic subjects and in symptomatic patients without the typical radiological findings. Nasopharyngeal swabbing appears a trivial procedure, still an inappropriate nasopharyngeal sampling, performed by untrained operators, can be a relevant cause of false negative findings with a clear negative impact on the effort

2020 American Journal of Otolaryngology

1513. Geospatial analysis of COVID-19 and otolaryngologists above age 60. Full Text available with Trip Pro

Geospatial analysis of COVID-19 and otolaryngologists above age 60. The 2019 novel coronavirus (COVID-19) is disproportionately impacting older individuals and healthcare workers. Otolaryngologists are especially susceptible with the elevated risk of aerosolization and corresponding high viral loads. This study utilizes a geospatial analysis to illustrate the comparative risks of older otolaryngologists across the United States during the COVID-19 pandemic.Demographic and state population data (...) were extracted from the State Physician Workforce Reports published by the AAMC for the year 2018. A geospatial heat map of the United States was then constructed to illustrate the location of COVID-19 confirmed case counts and the distributions of ENTs over 60 years for each state.In 2018, out of a total of 9578 practicing U.S. ENT surgeons, 3081 were older than 60 years (32.2%). The states with the highest proportion of ENTs over 60 were Maine, Delaware, Hawaii, and Louisiana. The states

2020 American Journal of Otolaryngology

1514. Practical insights for paediatric otolaryngology surgical cases and performing microlaryngobronchoscopy during the COVID-19 pandemic. Full Text available with Trip Pro

Practical insights for paediatric otolaryngology surgical cases and performing microlaryngobronchoscopy during the COVID-19 pandemic. Paediatric otolaryngology practice involves examining and operating in anatomical locations with high levels of aerosol generation and transmission of COVID-19 to treating clinicians, especially from the asymptomatic patient populations including children. During the COVID-19 pandemic all emergent otolaryngological conditions affecting the airway, oral, and nasal (...) cavities should be managed medically where possible and any operating deferred. We present guidelines for operating on paediatric otolaryngological patients when necessary during the COVID-19 pandemic, and incorporate experience gathered during microlaryngobronchoscopy on a COVID-19 positive infant at our institution.Copyright © 2020. Published by Elsevier B.V.

2020 International Journal of Pediatric Otorhinolaryngology

1515. Pediatric laryngoscopy and bronchoscopy during the COVID-19 pandemic: A four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes. Full Text available with Trip Pro

Pediatric laryngoscopy and bronchoscopy during the COVID-19 pandemic: A four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes. Aerosolization procedures during the COVID-19 pandemic place all operating room personnel at risk for exposure. We offer detailed perioperative management strategies and present a specific protocol designed to improve safety during pediatric laryngoscopy and bronchoscopy

2020 International Journal of Pediatric Otorhinolaryngology

1516. Minimizing contagion risks of COVID-19 during Trans Oral Robotic Surgery. Full Text available with Trip Pro

Minimizing contagion risks of COVID-19 during Trans Oral Robotic Surgery. In this communication we would like to share our experience in managing TORS patients during COVID-19 pandemia.This article is protected by copyright. All rights reserved.

2020 Laryngoscope

1517. BTK Inhibitors in Cancer Patients with COVID-19: "The Winner Will be the One Who Controls That Chaos" (Napoleon Bonaparte). Full Text available with Trip Pro

BTK Inhibitors in Cancer Patients with COVID-19: "The Winner Will be the One Who Controls That Chaos" (Napoleon Bonaparte). In the setting of the COVID-19 pandemic, providers must consider how to optimally manage patients with hematologic malignancies. There is rationale both for and against continuation of BTK inhibitors in patients receiving these drugs for management of CLL and B cell lymphomas. Herein, we describe both benefits and risks of BTK inhibitor continuation. In favor of BTKi (...) continuation, BTK plays an active role in macrophage polarization. By modulating key transcription factors, BTK may regulate macrophage polarization downstream of classic M1 and M2 polarizing stimuli and mitigate the hyperinflammatory state associated with COVID-19. In favor of BTKi discontinuation, we note a potentially increased risk of secondary infections and impaired humoral immunity. We hypothesize that the potential benefit of blunting a hyperinflammatory response to SARS-CoV-2 through attenuation

2020 Clinical Cancer Research

1518. Otolaryngology during COVID-19: Preventive care and precautionary measures. Full Text available with Trip Pro

Otolaryngology during COVID-19: Preventive care and precautionary measures. Since the outbreak of novel coronavirus disease (COVID-19) in December 2019, it has spread to various regions and countries, forming a global pandemic. Reducing nosocomial infection is a new issue and challenge for all healthcare systems. Otolaryngology is a high-risk specialty as it close contact with upper respiratory tract mucous, secretions, droplets and aerosols during procedures and surgery. Therefore, infection (...) prevention and control measures for this specialty are essential. Literatures on the epidemiology, clinical characteristics and infection control measures of COVID-19 were reviewed, practical knowledge from first-line otolaryngologists in China, the United States, and Brazil were reviewed and collated. It was recommended that otolaryngology professionals should improve screening in suspected patients with relevant nasal and pharyngeal symptoms and signs, suspend non-emergency consultations

2020 American Journal of Otolaryngology

1519. Brief guideline for the prevention of COVID-19 infection in head and neck and otolaryngology surgeons. Full Text available with Trip Pro

Brief guideline for the prevention of COVID-19 infection in head and neck and otolaryngology surgeons. Anatomically, viral density is greater in the nasal cavity and the nasopharynx. It is to be expected that instrumentation in or through those areas will entail a higher risk of transmission. That's why head and neck and otolaryngologist surgeons are among the most vulnerable health professionals.Surgeons should essentially perform procedures they require. Surgeries should be performed (...) with personal protective equipment suitable for the high risk of aerosolization: goggles, N95 face mask, facial mask, blood-repelling gown and gloves. It is advisable to have the cooperative COVID-19 test in all patients. Telemedicine is a useful resource if resources allow it.Otolaryngologists and related specialists are among the groups at higher risk when performing surgeries and upper airway examinations. There are no emergencies in a pandemic. The care of health professionals is crucial to combating

2020 American Journal of Otolaryngology

1520. Audiological profile of asymptomatic Covid-19 PCR-positive cases. Full Text available with Trip Pro

Audiological profile of asymptomatic Covid-19 PCR-positive cases. The current study compared the amplitude of transient evoked otoacoustic emissions (TEOAEs) and thresholds of pure-tone audiometry between asymptomatic COVID-19 PCR-positive cases and normal non-infected subjects.Twenty cases who were confirmed positive for COVID-19 and had none of the known symptoms for this viral infection formed the test group. Their age ranged between 20 and 50 years to avoid any age-related hearing affection (...) . Patients who had definite symptoms of COVID-19 infection as well as those who had a history of hearing loss or a history of any known cause of hearing loss were excluded from the examined sample. TEOAEs amplitude was measured for all participants.The high frequency pure-tone thresholds as well as the TEOAE amplitudes were significantly worse in the test group.COVID-19 infection could have deleterious effects on cochlear hair cell functions despite being asymptomatic. The mechanism of these effects

2020 American Journal of Otolaryngology

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