scholarly journals An operative barrier system for skull base and mastoid surgery: creating a safe operative theatre in the era of COVID-19

2020 ◽  
Vol 49 (1) ◽  
Author(s):  
Justin Cottrell ◽  
Justin Lui ◽  
Trung Le ◽  
Joseph Chen
Keyword(s):  
Skull Base ◽  
Middle Ear ◽  
Crucial Role ◽  
Healthcare Workers ◽  
Medical Procedure ◽  
Middle Ear Mucosa ◽  
Surgical Field ◽  
Surgical Suite ◽  
Surgical Teams ◽  
Mastoid Surgery

Abstract Within Neurotology, special draping systems have been devised for mastoid surgery recognizing that drilling of middle ear mucosa is an aerosol generating medical procedure (AGMP) which can place surgical teams at risk of COVID-19 infection. We provide a thorough description of a barrier system utilized in our practice, along with work completed by our group to better quantify its effectiveness. Utilization of a barrier system can provide near complete bone dust and droplet containment within the surgical field and prevent contamination of other healthcare workers. As this is an early system, further adaptations and national collaborations are required to ultimately arrive at a system that seamlessly integrates into the surgical suite. While these barrier systems are new, they are timely as we face a pandemic, and can play a crucial role in safely resuming surgery.

Preparing the surgical area for non-shaved ear surgery: a clinical assessment

2020 ◽  
Vol 29 (1) ◽  
pp. 68-72
Author(s):  
Dong-Hee Lee ◽  
Doyeon Kim
Keyword(s):  
Middle Ear ◽  
Medical Records ◽  
Bacterial Culture ◽  
Skin Incision ◽  
Bacterial Colonisation ◽  
Ear Surgery ◽  
Suppurative Otitis Media ◽  
Skin Contamination ◽  
Surgical Field ◽  
Mastoid Surgery

Objective: To review the clinical experience for non-shaved middle ear/mastoid surgery and evaluate the proper method of preparing the postauricular surgical field. Methods: This retrospective study reviewed medical records of cases where the non-shaved surgical procedure was carried out for middle ear/mastoid diseases. In all cases, middle ear and mastoid surgery was performed by one otologic surgeon without hair shaving to treat chronic perforation of tympanic membrane, as well as chronic suppurative otitis media, with or without mastoiditis during two years. The prevalence of surgical site infection (SSI) and bacterial culture of the surgical field was assessed just before the skin incision. Results: In this review of 106 cases, the SSI rate was 1.6% for the non-shaved ear surgery. Bacterial colonisation was found on the prepared surgical field in 8.5% of cases and these bacteria was different from true pathogens. SSI of the skin incision occurred in two cases, although no bacterial colonisation of the non-shaved surgical field was found. The surgical exposure of postauricular area was enough to do tympanoplasty or tympanomastoidectomy, even though in cases where a hairline was close to postauricular sulcus. Conclusion: This study showed that when preparing the non-shaved ear surgery, the surgeons should not have to worry about skin contamination by hair. We suggest that the non-shaved ear surgery would appear to be preferable for the postauricular approach.

Are mucin genes yet to be cloned expressed by human middle ear mucosa?

1998 ◽  
Vol 23 (3) ◽  
pp. 265-265 ◽  
Author(s):  
Hutton ◽  
Birchall ◽  
French ◽  
Kubba ◽  
Severn ◽  
...  
Keyword(s):  
Middle Ear ◽  
Middle Ear Mucosa ◽  
Mucin Genes ◽  
Human Middle Ear

scholarly journals Immunohistochemical and qPCR Detection of SARS-CoV-2 in the Human Middle Ear Versus the Nasal Cavity: Case Series

2021 ◽  
Author(s):  
Arwa Kurabi ◽  
Kwang Pak ◽  
Adam S. DeConde ◽  
Allen F. Ryan ◽  
Carol H. Yan
Keyword(s):  
Nasal Cavity ◽  
Middle Ear ◽  
Viral Infections ◽  
Case Series ◽  
Middle Ear Mucosa ◽  
Viral Receptor ◽  
Tissue Samples ◽  
Angiotensin Converting Enzyme 2 ◽  
Nasal Tissue ◽  
Human Middle Ear

AbstractViral infections have already been implicated with otitis media and sudden sensorineural hearing loss. However, the pathophysiology of COVID-19 as it relates to otologic disorders is not well-defined. With the spread of SARS-CoV-2, it is important to evaluate its colonization of middle ear mucosa. Middle ear and nasal tissue samples for quantitative RT-PCR and histologic evaluations were obtained from post-mortem COVID-19 patients and non-diseased control patients. Here we present evidence that SARS-CoV-2 colonizes the middle ear epithelium and co-localizes with the primary viral receptor, angiotensin-converting enzyme 2 (ACE2). Both middle ear and nasal epithelial cells show relatively high expression of ACE2, required for SARS-CoV-2 entry. The epithelial cell adhesion molecule (EpCAM) was use as a biomarker of epithelia. Furthermore, we found that the viral load in the middle ear is lower than that present in the nasal cavity.

scholarly journals Correlation between functional outcome and the SAMEO-ATO framework

2021 ◽  
Author(s):  
Vito Pontillo ◽  
Marialessia Damiani ◽  
Giusi Graziano ◽  
Nicola Quaranta
Keyword(s):  
Functional Outcome ◽  
Middle Ear ◽  
Petrous Bone ◽  
Canal Wall ◽  
Hearing Results ◽  
Tertiary Referral Center ◽  
Ossicular Reconstruction ◽  
Canal Wall Down ◽  
Mastoid Surgery ◽  
Canal Wall Up

Abstract Purpose To evaluate the recently proposed SAMEO-ATO framework for middle ear and mastoid surgery, by correlating it with the functional outcome in a large cohort of patients operated for middle ear and mastoid cholesteatoma in a tertiary referral center. Methods We retrospectively included all surgeries for middle ear and mastoid cholesteatoma undergone in our Department between January 2009 and December 2014, by excluding revision surgeries, congenital and petrous bone cholesteatoma. All surgeries were classified according to the SAMEO-ATO framework. The post-operative air bone gap (ABG) was calculated and chosen as benchmark parameter for the correlation analysis. Results 282 consecutive surgeries for middle ear and mastoid cholesteatoma were released in the study period on a total of 273 patients, with a mean age of 41.2 years. All patients were followed for an average period of 55.3 months. 54% of patients underwent M2c mastoidectomy (Canal Wall Down, CWD), while the remaining underwent Canal Wall Up (CWU) procedures, being M1b2a mastoidectomy the most common one (33%). Mean pre-operative and post-operative ABGs were 29.2 and 23.5 dB, with a significant improvement (p < 0.0001). ‘Mastoidectomy’ and ‘Ossicular reconstruction’ parameters of SAMEO-ATO showed significant association with postoperative ABG, with smaller residual gaps for the classes Mx and On, and worse hearing results for M3a and Ox. Conclusion Our results show the utility of SAMEO-ATO framework, and in particular of ‘M’ (Mastoidectomy) and ‘O’ (Ossicular reconstruction) parameters, in predicting the hearing outcome.

Atypical Pharyngitis In Suppurative Otitis Media Cases

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P98-P99
Author(s):  
Alaa A Abou-Bieh ◽  
Mona F Salama
Keyword(s):  
Middle Ear ◽  
Causative Organism ◽  
Isolation And Identification ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Gram Negative ◽  
Middle Ear Infection ◽  
Gram Negative Organisms ◽  
Micro Organisms ◽  
Middle Ear Cleft

Problem Unexplained persistent or recurrent bacterial pharyngitis in some patients who suffer from infected middle ear cleft. Methods Bacteriological swabs were obtained from both the ears and the pharynx of 37 cases with chronic otorrhea and perforation, whom complain of recurrent or persistent sore-throat. Then isolation and identification of the micro-organisms were done. This included examination of direct Gram stained films and cultures. Isolated Gram negative bacilli were subjected to further identification by the biochemical reactions and antibiotyping. Identical isolates from the same patient (ear and pharyngeal swabs) were subjected to further identification by genotyping using the pulsed field gel electrophoresis technique. Results 6 cases (16%) showed identity in phenotypes and genotypes for ear and pharyngeal samples from the same patient. All pharyngeal isolates were Gram negative organisms. 4 of them were Pseudomonas aeruginosa, 1 was Proteus sp., and 1 was Escherichia coli. All of these 3 species are not known to be among the primary organisms which may cause pharyngitis. Conclusion Bacterial pharyngitis in patients with chronically infected middle ear cleft may be attributed to the same organism invaded the middle ear mucosa. Also this study highlights some organisms as a pharyngeal invaders although they are not among the previously documented causatives of bacterial pharyngitis. But the study do not confirm the method of spread of these organisms and whether this was directly via the eustachian tube. Significance The study correlates the causative organism of the middle ear infection and that infected the pharyngeal mucosa utilizing the advanced bacteriological identification and genotyping techniques.

Histochemical Characteristics of Normal Middle Ear Mucosa

1972 ◽  
Vol 74 (1-6) ◽  
pp. 45-56 ◽  
Author(s):  
F. Hiraide ◽  
M. M. Paparella
Keyword(s):  
Middle Ear ◽  
Middle Ear Mucosa

Neural Control of the Middle Ear Mucosa

1988 ◽  
Vol 105 (sup457) ◽  
pp. 159-163
Author(s):  
Jukka Ylikoski ◽  
Igor Mrena ◽  
Pertti Panula ◽  
Olli Häppölä ◽  
Heikki Päivärinta
Keyword(s):  
Middle Ear ◽  
Neural Control ◽  
Middle Ear Mucosa

Blue Ear Drum and its Management

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 293-295 ◽  
Author(s):  
Michael M. Paparella
Keyword(s):  
Middle Ear ◽  
Proper Treatment ◽  
Blood Products ◽  
Ventilation Tube ◽  
Radical Mastoidectomy ◽  
Long Period ◽  
Modified Radical Mastoidectomy ◽  
Ventilation Tubes ◽  
Serous Otitis Media ◽  
Mastoid Surgery

The “blue ear drum” generally refers to a condition in which blood or blood products are found in the middle ear. After all possible causes for hemotympanum, including blood dyscrasias and trauma are searched for and ruled out, the patient may have chronic serous otitis media accompanied by bloody effusion. Treatment for all of these patients is conservative, consisting of medical therapy and, if need be, myringotomy and insertion of ventilation tubes. In spite of proper treatment, rarely the condition may progress, over a long period of time, to a state of intractability. Characteristic findings are a hypocellular mastoid, hyperplastic and metaplastic mucoperiosteal lining, including the presence of glands and cysts and Cholesterin granuloma. The recommended procedure is a modified radical mastoidectomy, placement of silicone rubber sheeting in the middle ear and insertion of a ventilation tube. It is to be emphasized that mastoid surgery is rarely indicated for these patients and only after all else has failed.

scholarly journals Global neurosurgery, Bangladesh and COVID-19 era

2020 ◽  
pp. 574-576
Author(s):  
Robert Ahmed Khan ◽  
Moshiur Rahman ◽  
Amit Agrawal ◽  
Ezequiel Garcia-Ballestas ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Developing Countries ◽  
Healthcare Workers ◽  
Surgical Care ◽  
Medical Procedure ◽  
Surgical Service ◽  
Training Process ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Obstacle ◽  
To Come

Background. COVID-19 has become an alarming pandemic for our earth. It has created panic not only in China but also in developing countries like Bangladesh. Bangladesh has adequate confinements to constrain the spread of the infection and in this circumstance, overall healthcare workers including neurosurgeons are confronting a ton of difficulties. The purpose of this paper is to depict the proficiency of Global neurosurgery in this COVID-19 time. Method. Global neurosurgery offers the chance of fusing the best proof-based guidelines of care. This paper demonstrated that, in low to middle-income countries, Global medical procedure has been received to address the issues of residents who lack critical surgical care. Results. Inappropriate and insufficient asset allotment has been a significant obstacle for the health system for decently giving security to the patients. The fundamental training process has been genuinely hampered in the current circumstance. Worldwide health activities have set to an alternate centre and Global neurosurgery as an assurance is slowed down. Conclusion. This paper recommended that Global neurosurgical activities need to come forward and increase the workforce to emphasize surgical service.

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