{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:58:09Z","timestamp":1786125489288,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T00:00:00Z","timestamp":1590796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>COVID-19 poses a risk to the endoscopic skull base surgeon. Significant efforts to improving safety have been employed, including the use of personal protective equipment, preoperative COVID-19 testing, and recently the use of a modified surgical mask barrier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To reduce the risks of pathogen transmission during endoscopic skull base surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This study was exempt from Institutional Review Board approval. Our study utilizes a 3-dimensional (3D)-printed mask with an anterior aperture fitted with a surgical glove with ports designed to allow for surgical instrumentation and side ports to accommodate suction ventilation and an endotracheal tube. As an alternative, a modified laparoscopic surgery trocar served as a port for instruments, and, on the contralateral side, rubber tubing was used over the endoscrub endosheath to create an airtight seal. Surgical freedom and aerosolization were tested in both modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The ventilated mask allowed for excellent surgical maneuverability and freedom. The trocar system was effective for posterior surgical procedures, allowing access to critical paramedian structures, and afforded a superior surgical seal, but was limited in terms of visualization and maneuverability during anterior approaches. Aerosolization was reduced using both the mask and nasal trocar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The ventilated upper airway endoscopic procedure mask allows for a sealed surgical barrier during endoscopic skull base surgery and may play a critical role in advancing skull base surgery in the COVID-19 era. The nasal trocar may be a useful alternative in instances where 3D printing is not available. Additional studies are needed to validate these preliminary findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opaa168","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T06:50:01Z","timestamp":1590821401000},"page":"271-280","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":19,"title":["Ventilated Upper Airway Endoscopic Endonasal Procedure Mask: Surgical Safety in the COVID-19 Era"],"prefix":"10.1227","volume":"19","author":[{"given":"Samuel N","family":"Helman","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5961-2173","authenticated-orcid":false,"given":"Roberto M","family":"Soriano","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin L","family":"Tomov","sequence":"additional","affiliation":[{"name":"Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahid","family":"Serpooshan","sequence":"additional","affiliation":[{"name":"Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine, Georgia Institute of Technology, Atlanta, Georgia"},{"name":"Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia"},{"name":"Children's Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua M","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Pradilla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Arturo","family":"Solares","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia"},{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,9]]},"reference":[{"issue":"1","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"E66","DOI":"10.1093\/neuros\/nyaa125","article-title":"Letter: precautions for endoscopic transnasal skull base surgery during the COVID-19 pandemic","volume":"87","author":"Patel","year":"2020","journal-title":"Neurosurgery"},{"key":"bib2-20240909","article-title":"Endonasal instrumentation and aerosolization risk in the era of COVID-19: simulation, literature review, and proposed mitigation strategies.","author":"Workman","journal-title":"Int Forum Allergy Rhinol."},{"key":"bib4-20240909","doi-asserted-by":"crossref","DOI":"10.1093\/neuros\/nyaa145","article-title":"In reply: precautions for endoscopic transnasal skull base surgery during the COVID-19 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fossae","volume":"77","author":"Upadhyay","year":"2016","journal-title":"J Neurol Surg B."},{"issue":"5","key":"bib11-20240909","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1002\/lary.24502","article-title":"An inexpensive blue filter for fluorescein-assisted repair of cerebrospinal fluid rhinorrhea","volume":"124","author":"Singh","year":"2014","journal-title":"Laryngoscope."}],"container-title":["Operative 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