Cochlear implant surgery in the COVID era – recording now available

On 2nd of June 2020, BCIG organised a virtual round table. Chaired by BCIG Chair Helen Cullington and supported by 4 UK CI surgeons they discussed the prioritisation of cases, preop considerations, intraop modifications, risk of postop COVID and implications for consent, remote surgical follow up, and much more.
The recording is now available YouTube, see video below:

Watch out for the announcement of our next round table, which will cover the in-clinic aspects for adults and children – waiting lists, prioritisation, outreach, PPE, remote care etc.

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Feedback from session:

 

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Other useful links discussed at the meeting:
Microscope draping presentation
Droplets and Aerosols presentation
ENTUK
The 2 Microscope Drape Method to Reduce Aerosolization
Royal College of Surgeons
Clinical guide to surgical prioritisation during the coronavirus pandemic
British Society of Otology
The Ocular Manifestations and Transmission of COVID19 Recommendations for Prevention
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Professor Doug Hartley kindly shared this manuscript summary from their article submitted to Laryngoscope in June 2020:
Recovery of Cochlear Implant and Mastoid Surgery during COVID19

We undertook a preclinical evaluation of PPE for cochlear implant and other mastoid surgery during COVID19. Our aim was to devise a system that not only protected the airways of the surgeon but also prevented contamination of the mucous membranes around the eye while undertaking these aerosolising procedures.

Using a systematic risk based-approach to analyse a range of PPEs, we found the combination of a half-face mask (e.g. FFP3 mask or half-face respirator) and safety spoggles (foam lined safety goggles) consistently performed better than other PPE options across all aspects of clinical usability. The CE marked safety spoggles we evaluated (Bollé Baxter – BAXPSI) met safety standards to protect against liquid droplets or splashes, large dust particles > 5 microns, and gas and fine dust particles <5 microns (equivalent to <5μm). We measured the visual fields across surgeons using the spoggles and, in contrast to other PPEs we evaluated, they had minimal effect on the field of vision through the operating microscope. Bollé also advertise prescription spoggles (Bollé Baxter Rx – BAXN) on their website for those who need to wear corrective glasses to operate.

In addition, our preclinical model confirmed a significant reduction of drill-induced droplet spread using the ‘Southampton double-microscope drape’ method.

Thus, for the safe resumption of cochlear implant and mastoid surgery, we recommend the PPE ensemble of an FFP3 mask or half-face respirator (eg GVC Elipse or JSP Force8) coupled with spoggles (eg Bollé Baxter – BAXPSI). This PPE recommendation has been approved by the Surgical Division of Nottingham University Hospitals NHS Trust.