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One year into the COVID-19 pandemic: What do we know so far from studies assessing risk and mitigation of droplet aerosolisation during endonasal surgery? A systematic review
  • Stephen Williams,
  • Samuel Leong
Stephen Williams
Liverpool University Hospitals NHS Foundation Trust
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Samuel Leong
Liverpool University Hospitals NHS Foundation Trust
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Objectives As we pass the anniversary of the declaration of a global pandemic by the World Health Organisation, it invites us to reflect upon the inescapable changes that coronavirus has wrought upon ENT and, in particular, rhinological practice. As it remains unclear when we will globally emerge from the shadow of COVID-19, a critical analysis of the evidence base on both the assessment and mitigation of risk is vital for ENT departments worldwide. This article presents a systematic review of the literature examining articles which consider either the quantification of risk or strategies to mitigate risk specifically in the setting of rhinological surgery. Design Systematic literature review. Results The literature search yielded a total of 3406 returns with 24 articles meeting eligibility criteria. A narrative synthesis stratified results into two broad themes: those which made an assessment as to the aerosolisation of droplets during sinus surgery, further subdivided into work which considered macroscopically visible droplets and that which considered smaller particles, and those studies which examined the mitigation of this risk. Conclusion Studies considering the aerosolisation of both droplets and smaller particles suggest endonasal surgery carries significant risk. Whilst results both highlight a range of innovative adjunctive strategies and support suction as an important variable to reduce aerosolisation, appropriate use of personal protective equipment (PPE) should be considered mandatory for all healthcare professionals involved in rhinological surgery given studies have demonstrated that close adherence to PPE use is effective at preventing COVID-19 infection.
25 Apr 2021Submitted to Clinical Otolaryngology
28 Apr 2021Submission Checks Completed
28 Apr 2021Assigned to Editor
09 May 2021Reviewer(s) Assigned
19 Jun 2021Review(s) Completed, Editorial Evaluation Pending
06 Jul 2021Editorial Decision: Revise Major
26 Jul 20211st Revision Received
27 Jul 2021Submission Checks Completed
27 Jul 2021Assigned to Editor
27 Jul 2021Reviewer(s) Assigned
21 Aug 2021Review(s) Completed, Editorial Evaluation Pending
22 Aug 2021Editorial Decision: Accept