{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T04:50:43Z","timestamp":1767156643939,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T00:00:00Z","timestamp":1597449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007155","name":"Medical Research Council Canada","doi-asserted-by":"publisher","award":["MR\/R017344\/1"],"award-info":[{"award-number":["MR\/R017344\/1"]}],"id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>The overall aim of this study was to evaluate personal protective equipment (PPE) that may facilitate the safe recommencement of cochlear implantation in the COVID\u201019 era, with the broader goal of minimizing the period of auditory deprivation in prelingually deaf children and reducing the risk of cochlear ossification in individuals following meningitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study design comprised 1) an objective assessment of mastoid drilling\u2010induced droplet spread conducted during simulated cochlear implant (CI) surgery and its mitigation via the use of a protective drape tent and 2) an evaluation of three PPE configurations by otologists while performing mastoid drilling on ex vivo temporal bones. The various PPE solutions were assessed in terms of their impact on communication, vital physiological parameters, visual acuity and fields, and acceptability to surgeons using a systematic risk\u2010based approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Droplet spread during simulated CI surgery extended over 2\u2009m, a distance greater than previously reported. A drape tent significantly reduced droplet spread. The ensemble of a half\u2010face mask and safety spoggles (foam lined safety goggles) had consistently superior performance across all aspects of clinical usability. All other PPE options were found to substantially restrict the visual field, making them unsafe for microsurgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of this preclinical study indicate that the most viable solution to enable the safe conduct of CI and other mastoid surgery is a combination of a filtering facepiece (FFP3) mask or half\u2010face respirator with safety spoggles as PPE. Prescription spoggles are an option for surgeons who need to wear corrective glasses to operate. A drape tent reduces droplet spread. A multicenter clinical trial to evaluate the effectiveness of PPE should be the next step toward safely performing CI surgery during the COVID\u201019 era.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 130:2693\u20132699, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29014","type":"journal-article","created":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T05:18:51Z","timestamp":1595913531000},"page":"2693-2699","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Recommended Personal Protective Equipment for Cochlear Implant and Other Mastoid Surgery During the <scp>COVID<\/scp>\u201019 Era"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3990-9724","authenticated-orcid":false,"given":"Rachael J.","family":"Lawrence","sequence":"first","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre Ropewalk House  Nottingham United Kingdom"},{"name":"Hearing Sciences, Division of Clinical Neuroscience, School of Medicine University of Nottingham  Nottingham United Kingdom"},{"name":"Nottingham University Hospitals National Health Service Trust  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard","family":"O'Donoghue","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre Ropewalk House  Nottingham United Kingdom"},{"name":"Hearing Sciences, Division of Clinical Neuroscience, School of Medicine University of Nottingham  Nottingham United Kingdom"},{"name":"Nottingham University Hospitals National Health Service Trust  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e1draig","family":"Kitterick","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre Ropewalk House  Nottingham United Kingdom"},{"name":"Hearing Sciences, Division of Clinical Neuroscience, School of Medicine University of Nottingham  Nottingham United Kingdom"},{"name":"Nottingham University Hospitals National Health Service Trust  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"O'Donoghue","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals National Health Service Trust  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Hague","sequence":"additional","affiliation":[{"name":"Centre for Additive Manufacturing University of Nottingham  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals National Health Service Trust  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Lycett\u2010Ranson","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals National Health Service Trust  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas E.H.","family":"Hartley","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Nottingham Biomedical Research Centre Ropewalk House  Nottingham United Kingdom"},{"name":"Hearing Sciences, Division of Clinical Neuroscience, School of Medicine University of Nottingham  Nottingham United Kingdom"},{"name":"Nottingham University Hospitals National Health Service Trust  Nottingham United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30292-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-020-03874-z"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-020-00424-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","unstructured":"ChenJX WorkmanAD ChariDA et al. Demonstration and mitigation of aerosol and particle dispersion during mastoidectomy relevant to the COVID\u201019 era [published online May 8 2020].Otol Neurotoldoi:https:\/\/doi.org\/10.1097\/MAO.0000000000002765.","DOI":"10.1097\/MAO.0000000000002765"},{"key":"e_1_2_7_6_1","unstructured":"Canadian Society of Otolaryngology\u2010Head & Neck Surgery. Guideline for healthcare workers performing aerosol generating medical procedures during the COVID\u201019 pandemic. Available at:https:\/\/www.entcanada.org\/wp-content\/uploads\/Protocol-for-COVID-and-AGMP-3-iw-mailer.pdf. Accessed May 27 2020."},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","unstructured":"XuK LaiX LiuZ.Suggestions on the prevention of COVID\u201019 for health care workers in department of otorhinolaryngology head and neck surgery [published online April 2 2020].World J Otorhinolaryngol Head Neck Surgdoi:https:\/\/doi.org\/10.1016\/j.wjorl.2020.03.002.","DOI":"10.1016\/j.wjorl.2020.03.002"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","unstructured":"VukkadalaN QianZJ HolsingerFC PatelZM RosenthalE.COVID\u201019 and the otolaryngologist: preliminary evidence\u2010based review [published online March 26 2020].Laryngoscopedoi:https:\/\/doi.org\/10.1002\/lary.28672.","DOI":"10.1002\/lary.28672"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","unstructured":"PatelZM Fernandez\u2010MirandaJ HwangPH et al. Precautions for endoscopic transnasal skull base surgery during the COVID\u201019 pandemic [published online April 15 2020].Neurosurgerydoi:https:\/\/doi.org\/10.1093\/neuros\/nyaa125.","DOI":"10.1093\/neuros\/nyaa125"},{"key":"e_1_2_7_10_1","unstructured":"HellierWMitchellT ThomasS.ENT UK and British Society of Otology.Mastoidectomy in the COVID era\u2014the 2 microscope drape method to reduce aerosolization. Available at:https:\/\/www.entuk.org\/sites\/default\/files\/Mastoidectomy%20in%20the%20COVID%20Era%20\u2013%20The%202.pdf. Accessed May 27 2020."},{"key":"e_1_2_7_11_1","unstructured":"Lumistick glow sticks. Available at:https:\/\/www.amazon.co.uk\/gp\/product\/B001GRCYDW\/ref=ppx_yo_dt_b_asin_title_o03_s00?ie=UTF8&psc=1. Accessed May 27 2020."},{"key":"e_1_2_7_12_1","unstructured":"Stanford Bioengineering Prakash Lab. The Pneumask project. Available at:https:\/\/www.pneumask.org. Accessed May 11 2020."},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/00381796809075436"},{"key":"e_1_2_7_14_1","unstructured":"Peek Vision Ltd. Peek Acuity. Available at:https:\/\/www.peekvision.org\/en_GB\/peek-solutions\/peek-acuity\/. Accessed May 11 2020."},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000177459.80574.2d"},{"key":"e_1_2_7_16_1","unstructured":"MorrisLA.Health and Safety Executive Contract Research Report No. 27\/1991. Dead space and inhaled carbon dioxide levels in respiratory protective equipment. Available at:https:\/\/www.hse.gov.uk\/research\/crr_pdf\/1991\/CRR91027.pdf. Accessed May 27 2020."},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00140139.2013.777128"},{"key":"e_1_2_7_18_1","unstructured":"British Standards Institution.BS EN 13274\u20136:2002. Respiratory protective devices\u2014methods of test\u2014Part 6: determination of carbon dioxide content of the inhalation. Available at:https:\/\/shop.bsigroup.com\/ProductDetail?pid=000000000030013570. Accessed May 27 2020."},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2019.06.023"},{"key":"e_1_2_7_20_1","unstructured":"Public Health England. Guidance \u2010 COVID\u201019: epidemiology virology and clinical features. Available at:https:\/\/www.gov.uk\/government\/publications\/wuhan\u2010novel\u2010coronavirus\u2010background\u2010information\/wuhan\u2010novel\u2010coronavirus\u2010epidemiology\u2010virology\u2010and\u2010clinical\u2010features#:~:text=According%20to%20current%20evidence%2C and%20control%20guidance). Accessed August 12 2020."},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-3707-y"},{"volume-title":"Aerosol Technology","year":"1999","author":"Hinds WC","key":"e_1_2_7_22_1"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-6553(98)70046-X"},{"key":"e_1_2_7_24_1","doi-asserted-by":"crossref","unstructured":"ClampP BroomfieldS.The challenge of performing mastoidectomy using the operating microscope with COVID\u201019 personal protective equipment [published online July 28 2020].J Laryngol Otoldoi:https:\/\/doi.org\/10.1017\/S0022215120001607. Click here to enter text.","DOI":"10.1017\/S0022215120001607"},{"key":"e_1_2_7_25_1","unstructured":"Boll\u00e9 prescription safety glasses. Available at:https:\/\/www.bolle-safety.com\/models\/prescription-safety-glasses. Accessed May 27 2020."},{"key":"e_1_2_7_26_1","unstructured":"3M eyewear fit system. Available at:https:\/\/www.3m.co.uk\/3M\/en_GB\/worker-health-safety-uk\/safety-solutions\/eye-protection-centre\/eyewear-fit-system\/. Accessed May 27 2020."}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.29014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29014","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T04:06:25Z","timestamp":1693713985000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,15]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1002\/lary.29014"],"URL":"https:\/\/doi.org\/10.1002\/lary.29014","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2020,8,15]]},"assertion":[{"value":"2020-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}