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Multicenter Study
. 2022 Jul;18(4):347-357.
doi: 10.5152/iao.2022.21482.

Safety of Otological Operating During the COVID-19 Pandemic: A National Prospective Audit of 1130 Cases from 79 Centers

Elinor Warner #  1 , Reshma Ghedia #  1 , Anton Alatsationos  2 , Simon Lloyd  3 , Peter Rea  4 , Felicity Kay Seymour  1 ; British Society of Otology (BSO) Study group
Collaborators, Affiliations
Multicenter Study

Safety of Otological Operating During the COVID-19 Pandemic: A National Prospective Audit of 1130 Cases from 79 Centers

Elinor Warner et al. J Int Adv Otol. 2022 Jul.

Abstract

Background: To assess compliance with guidance produced by the UK body representing all ENT Surgeons (ENT UK) and the British Society of Otology (BSO) on restarting otological surgery after the first wave of the COVID-19 pandemic. Safety was assessed by recording surgical complica- tions and transmission of SARS-CoV-2 transmission during this period.

Methods: A prospective multicenter audit of otological surgery was conducted over a 12-week period, from June 15, 2020, to September 6, 2020.

Results: One thousand one hundred thirty cases from 79 hospital sites across Great Britain were involved in the study; 91.1% were tested for SARS-CoV-2 pre-operatively, none of whom tested positive; 70.4% were isolated for 7-14 days prior to surgery; 28.2% of surgeons wore full personal protective equipment, compared with 66.6% of anesthetists and 68.2% of scrub staff. The endoscope was used in 75 (6.7%) of all proce- dures, operations were changed to be performed under local rather than a general anesthetic in 3 cases (0.3%) and the "double drape" to protect against aerosol was used in 321 (27.4%) of cases. Trainees were present in 80.3% of cases. Complications occurred in 4% of cases. No patients or staff contracted SARS-CoV-2 during the audit.

Conclusion: ENT UK and BSO guidance was variably followed, with the highest compliance for the use of an FFP3 mask, a negative SARS-CoV-2 swab, and trainee presence in theater. Surgeons did not use full personal protective equipment as frequently as their anesthetic and scrub team colleagues. There were only minimal changes in surgical and anesthetic techniques. Otological operation after the first wave of the SARS- CoV-2 pandemic was performed safely with no reported COVID transmission or increase in major complications despite changes in operating practice.

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Figures

Figure 1. a-c.
Figure 1. a-c.
(a) Operations by category, changes in operating capacity over time. (b) Hearing implant operations, changes in operating capacity over time. (c) Cochlear implantation, changes in population receiving implant over time.
Figure 2.
Figure 2.
Trainee presence in theater by region.
Figure 3.
Figure 3.
Operative complications.
See this image and copyright information in PMC

References

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