‘POLIDON’ Approach-A Novel Approach of Mastoidectomy in the COVID-19 Pandemic
1Otolaryngologist, Department of ENT & Head Neck Surgery, Dhaka Medical College hospital, Bangladesh
2Consultant, ENT and Head Neck Cancer Hospital & Institute, Bangladesh
3Registrar, Department of ENT & Head Neck Surgery, Dhaka Medical College Hospital, Bangladesh
4Medical Officer, Department of Neurosurgery, Dhaka Medical College Hospital, Bangladesh
5Assistant Professor, Department of ENT & Head Neck Surgery, Dhaka Medical College Hospital, Bangladesh
6Assistant Professor, Department of ENT & Head Neck Surgery, Satkhira Medical College Hospital, Bangladesh
7Assistant Professor, Department of ENT & Head Neck Surgery, Jashore Medical College, Bangladesh
8Associate Professor, Department of ENT & Head Neck Surgery, Dhaka Medical College Hospital, Bangladesh
9Professor & Head, Department of ENT & Head Neck Surgery, Dhaka Medical College Hospital, Bangladesh
10Professor and Head, Department of Otolaryngology-Head & Neck Surgery, Bangladesh Medical College Hospital, Bangladesh
11Professor of Otolaryngology & Line Director, Medical education and Health Manpower Development, Directorate General of Medical Education, Bangladesh
12Professor of Otolaryngology & Additional Director General, Directorate General of Health Service, Bangladesh
13Director, Dhaka Medical College Hospital, Bangladesh
Received Date: August 27, 2020; Published Date: September 16, 2020
Background: WHO declared COVID-19 outbreak as pandemic in March, 2020, which was started from Wuhan of china. Mastoidectomy is an aerosol generating procedure. If a patient of COVID-19, either confirmed, suspected or asymptomatic career, requires mastoidectomy urgently, it’s a critical issue for the health care professionals for the highly contagious nature of this novel corona virus. Here, some simple, but novel and very effective measures will be discussed for protection of all health care providers (HCPs). Polythene sheet and Povidone Iodine are the change makers in this novel approach of mastoidectomy, mentioned in this article. So, we named the technique as ‘POLIDON approach’ of mastoidectomy.
Material and method: Placement of a transparent, sterile polythene sheet which acts as an interface between patient and surgeons and all other OR staffs is an important issue. Meanwhile, extended use of Povidone Iodine (PVP-I) is recommended in different way. Mouthwash for gargling and nasal application either by spray or nasal irrigation or drop will reduce viral load from nose and mouth of patient. HCPs should use PVP-I prophylactically also. Thus, the chance of transmissibility of novel coronavirus is reduced. Meanwhile, Povidone Iodine should be mixed with irrigating fluid to help in reduction of contamination by bone dust mixed with fluid, produced during surgery.
Conclusion: As mastoidectomy is an aerosol generating procedure, and novel coronavirus is highly contagious, so higher level of protection is required. A simple and cheap polythene sheet as barrier drape as well as rational and novel use of Povidone Iodine, i.e. the proposed ‘POLIDON’ approach can significantly reduce the chance of corona virus transmission among the health care professionals working in the operation theatre.
Keywords: POLIDON; Mastoidectomy; COVID-19; Povidone Iodine; Polythene
Abbreviations: PVP-I: Povidone Iodine; HCP: Health care provider