AB121. SOH21AS070. ENT surgical modifications during COVID-19

Background: The use of FFP3 face masks during the rapidly developing COVID-19 pandemic has raised some concerns among ENT surgeons. The non-realistic perspective that a single FFP3 mask fits every facial type with surgeons being fit-tested for a mask type only to be subsequently dispensed and replaced with a different brand on the day of surgery and the problem for surgeons with facial hair for religious or cultural reasons who fail fit testing with every FFP3 mask type. The powered air-purifying respirators (PAPRs) provides a suitable alternative with the capability of providing ten times the nominal protection of an FFP3 mask and has been deemed to be the best respiratory protective equipment (RPE) available.

Methods: To review our experience with the utility of the PAPRs in different ENT procedures during the COVID-19 pandemic highlighting the proposed advantages and drawbacks for their use in different ENT sites and the surgical modifications adapted for them to be convenient to use.

Results: The PAPRs have proven to be an effective alternative to FFP3 masks being easy to use, providing a panoramic view with clean air, low resistance breathing, and no fit-testing required. Their use has required certain surgical modifications because of difficulties encountered especially with microscopic procedures where the equipped surgeon had to rely mainly on total endoscopic technique.

Conclusions: The PAPR is a useful and effective personnel protective equipment, although not applicable for all ENT procedures, it has proven to provide a convenient alternative to surgeons who are not able to use the ordinary non-powered FFP3 masks.

Keywords: Severe acute respiratory syndrome coronavirus 2; personal protective equipment; powered air-purifying respirator (PAPR); respiratory protective equipment (RPE); total endoscopic ear surgery