J Neurol Surg B Skull Base 2022; 83(S 02): e169-e172
DOI: 10.1055/s-0041-1722936
Original Article

Skull Base Aerosol Generating Cases Amidst the COVID-19 Pandemic: An Experience from the Epicenter

Yosef Dastagirzada
1   Department of Neurosurgery, NYU Langone Health, New York City, New York, United States
,
Olga Klauberg
1   Department of Neurosurgery, NYU Langone Health, New York City, New York, United States
,
Kathleen Sheerin
1   Department of Neurosurgery, NYU Langone Health, New York City, New York, United States
,
Seth Lieberman
2   Department of Otolaryngology, NYU Langone Health, New York City, New York, United States
,
Richard Lebowitz
2   Department of Otolaryngology, NYU Langone Health, New York City, New York, United States
,
Sean McMenomey
2   Department of Otolaryngology, NYU Langone Health, New York City, New York, United States
,
Chandranath Sen
1   Department of Neurosurgery, NYU Langone Health, New York City, New York, United States
,
J Thomas Roland
2   Department of Otolaryngology, NYU Langone Health, New York City, New York, United States
,
1   Department of Neurosurgery, NYU Langone Health, New York City, New York, United States
,
Donato Pacione
1   Department of Neurosurgery, NYU Langone Health, New York City, New York, United States
› Author Affiliations
Funding None.

Abstract

Soon after the World Health Organization declared the severe acute respiratory syndrome coronavirus 2 a global health emergency on January 30, 2020, New York City was plagued by the virus and its health system and economy pushed to their limits. The majority of the limited neurosurgical data in relation to COVID-19 is anecdotal and the higher theoretical risk of transmission of the virus among skull base aerosol generating (SBAG) cases has not been investigated or discussed in a neurosurgical population. We discuss a series of 13 patients who underwent 15 SBAG surgical procedures during the peak of COVID-19 in our hospital system and the protocols use perioperatively for their procedures. Our data support that with proper preoperative testing, a well-delineated surgical algorithm, and appropriate personal protective equipment, emergent/urgent cases can be done safely in hospitals that are currently experiencing high volumes of COVID-19 cases as we did in March to May of 2020.



Publication History

Received: 11 August 2020

Accepted: 03 December 2020

Article published online:
18 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395 (10223): 497-506
  • 2 World Health Organization (WHO). WHO coronavirus disease (COVID-19) Dashboard. Accessed 2020 at: https://covid19.who.int/
  • 3 Zou L, Ruan F, Huang M. et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020; 382 (12) 1177-1179
  • 4 van Doremalen N, Bushmaker T, Morris DH. et al. Aerosol and surface stability of hcov-19 (sars-cov-2) compared to sars-cov-1. N Engl J Med 2020; 382 (16) 1564-1567
  • 5 Patel ZM, Fernandez-Miranda J, Hwang PH. et al. Precautions for endoscopic transnasal skull base surgery during the COVID-19 pandemic. Neurosurgery 2020; 87 (01) E66-E67
  • 6 Lo YT, Yang Teo NW, Ang BT. Editorial. Endonasal neurosurgery during the COVID-19 pandemic: the Singapore perspective. J Neurosurg 2020; (Apr): 1-3
  • 7 Castelnuovo P, Turri-Zanoni M, Karligkiotis A. et al; Italian Skull Base Society Board, Italian Skull Base Society Board (Società Italiana Basicranio [SIB]). Skull-base surgery during the COVID-19 pandemic: the Italian Skull Base Society recommendations. Int Forum Allergy Rhinol 2020; 10 (08) 963-967
  • 8 Merkler AE, Parikh NS, Mir S. et al. Risk of ischemic stroke in patients with coronavirus disease 2019 (COVID-19) vs patients with influenza. JAMA Neurol 2020; E1-E7
  • 9 Wu Y, Xu X, Chen Z. et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun 2020; 87: 18-22
  • 10 Ellul MA, Benjamin L, Singh B. et al. Neurological associations of COVID-19. Lancet Neurol 2020; 19 (09) 767-783
  • 11 Workman AD, Welling DB, Carter BS. et al. Endonasal instrumentation and aerosolization risk in the era of COVID-19: simulation, literature review, and proposed mitigation strategies. Int Forum Allergy Rhinol 2020; 10 (07) 798-805
  • 12 Radulesco T, Lechien JR, Sowerby LJ. et al. Sinus and anterior skull base surgery during the COVID-19 pandemic: systematic review, synthesis and YO-IFOS position. Eur Arch Otorhinolaryngol 2020; DOI: 10.1007/s00405-020-06236-9.
  • 13 Zhu W, Huang X, Zhao H, Jiang X. A COVID-19 patient who underwent endonasal endoscopic pituitary adenoma resection: a case report. Neurosurgery 2020; 87 (02) E140-E146