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Draping Technique for Major Ear Surgery during Pandemic!!!

Covid -19 Pandemic has changed the way we provide our healthcare services to our patients. ENT / Otolaryngology is one of the high risk speciality for contracting Covid infection. We as  professionals has to take maximum precautions not only to protect our patients but also all our healthcare staff working with us in to minimise the risk of contracting the virus ((Krajewska).

Unfortunately our patients do need appropriate necessary treatment for their otological problems during this pandemic. Drilling mastoid bone will generate significant aerosol during the procedure, putting everyone in the operating theatre at risk (Prof P Rae). Though every patient who undergoes any surgical procedure should have Covid test, self isolate and free from Covid symptoms. There is risk of contracting Covid infection from asymptomatic patient or staff. We should try and take every step to minimise the risk of  contracting Covid infection either from Covid positive / negative Or symptomatic / asymptomatic patient or staff.

There are few techniques been tried by our colleagues around the world to minimise aerosol during major ear surgery.  We tried to use of the technique proposed by our colleagues in UK ( W. Hellier), as it was too cumbersome during the procedure, we propose the modified technique to drape the surgical site during major ear surgery to reduce the aerosol.

Major ear procedure - revision mastoidectomy
Severe recurrent ear infection (CSOM)
None
Secondary care - Hospital setting
Two week self isolation Covid test - negative Pre-assessment workup
Temporal bone, Mastoid External canal Facial ridge Lateral semi-circular canal Tegmen Sino-Dural angle
Only way to clear infection from the mastoid bone Helps to recover from recurrent infection Protect hearing and other complication Undergoing surgery
Risk of GA, facial nerve damage, hearing loss, recurrent infection
None
None
1. J Krajewska, W Krajewski et,al,: Review of practical recommendations for Otolaryngologists and head and neck surgeons during the COVID -19 pandemic; REcommendation for otolaryngologists during the COVID-19 Pandenmic. Audi’s Natus Larynx. 2020 June 6 dol:10.1016/j.anl2020.05.022. 2. Prof P Rae, Prof S Lloyd and Dr D Jenkins. Guidance for undertaking otological procedures during COVID-19 Pandemic.www.ENTUK.org/covid 3. W. Hellier, T Mitchell and S Thomas. Mastoidectomy in the COVID Era - The 2 Microscope Drape Method to Reduce Aerosolization.www.ENTUK.org/covid.

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