Novel Solution for the ENT and Skull Base Surgeons in COVID-19 Era: A ‘POLIDON’ Approach

Abstract

This chapter highlights about novel solution for the ENT and skull base surgeons in COVID-19 Era. Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset in the end of 2019. As the case numbers of COVID-19 have increased worldwide, it has become more apparent that the elevated viral load in the upper aerodigestive tract mucosa not only affects skull base surgery but essentially all diagnostic and therapeutic intranasal procedures that are routinely part of the scope of practice for Otolaryngologist - Head and Neck Surgeons. The majority of endoscopic and microscopic ENT and skull base surgeries, such as pituitary gland and mastoid surgery, are AGP procedures. We considered eradicating or neutralizing the new coronavirus at its point of introduction. As far as we are aware, RT-PCR testing does not always result in a COVID negative result. For this reason, even cancer surgeries are discouraged, avoided, or delayed in the COVID-19 pandemic routine in order to protect healthcare professionals. Moreover, in case of surgical emergency there’s no way to refuse a patient for not having a report of COVID test. We designed and proposed a novel approach, i.e. ‘POLIDON’ (POLIDON= Polythene + Povidone Iodine), which can be the ultimate hope or solution for these unfortunate patients as well as surgeons or HCPs of above mentioned specialties. Interestingly, among twelve different health care providers, including doctors, nurses and OT staffs, directly involved and exposed in these two surgeries, none of them were infected/were not infected. Importantly, ‘POLIDON’ approach was followed in both the procedures.