Awareness of an Primitive Art for Treating Otological Diseases in Present Covid-19 Scenario: Need of the Hour
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Awareness of an Primitive Art for Treating Otological Diseases in Present Covid-19 Scenario: Need of the Hour Sweta Soni1 • Nisha shrivastava1 • Bhartendu Bharti2 • Vijay kumar1 Rudra prakash1 • Swati Suneha1 • Saraj K. Singh3 • Kranti Bhavana1
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Received: 2 October 2020 / Accepted: 16 October 2020 Association of Otolaryngologists of India 2020
Abstract In current scenario of Covid-19 pandemic spread of virus via aerosol generating procedures has become a special concern in otorhinolaryngology community. Motive of this study is to spread awareness of an ancient forgotten method of performing mastoidectomy through which risk of virus infection can be greatly reduced among otologic surgeons. Retrospective Observational study. Three patients of chronic otitis media with complication were operatively intervened with combined approach of otorhinolaryngology and neurosurgeons. Mastoidectomies were performed without drilling. Instruments used were small, medium and large size gouge, chisel and hammer, curettes, kerrison punches and other microscopic ear instruments. All three patients recovered well without any residual disease or cavity problems. Referring ancient practices like above in this COVID era may prove an important tool in addressing surgical urgencies while combating transmission risks at the same time. One should be vigilant and versatile in surgical techniques in order to serve the needy and save the saviours simultaneously. Keywords Mastoidectomies in Covid era Primitive mastoidectomy Chisel and hammer mastoid surgery
& Bhartendu Bharti [email protected] 1
Department of ENT, All India Institute of Medical Sciences, Patna, India
2
Department of Otorhinolaryngology and Head and Neck Surgery, Department of ENT, All India Institute of Medical Sciences, Patna, India
3
Department of Neurosurgery, All India Institute of Medical Sciences, Patna, India
Introduction Covid-19 pandemic has changed our modern day medical practice in numerous different ways. Challenges are there not only in managing patients but also in preventing transmission of this disease to health care professionals. This has led to several modifications in approach to patients and their surgical management. Mastoid surgery being a significant aerosol generating procedure, owing to drilling and continuous irrigation, requires absolute indications and should be limited to emergency procedures only during the pandemic. Using gouge and hammer to perform mastoid exploration causes much less aerosol generation as the bone chips are larger and heavier pieces of bone that tends to stay around the surgical field without much spread in and around the area. We present here series of three cases of emergency modified radical mastoidectomy done using a gouge and hammer instead of a drill. In this study we intend to demonstrate an ancient method of performing mastoid procedures which becomes the need of the hour by decreasing the amount of aerosol generation to minimum and make the procedure safer and secure for all O
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