COVID-19社區感染嚴重時期的耳科檢查處置與手術建議

自2019年底以來，2019新型冠狀病毒肺炎（COVID-19）大流行席捲全球。以往文獻曾報導中耳和乳突中存在有其他冠狀病毒，這表示在常使用霧化步驟的耳部手術中存在著醫護人員感染的風險。因此，在許多耳科手術中，由於中耳和上呼吸道相通，有很高風險COVID-19病原體會經由飛沫氣霧從上呼吸道傳播到中耳。本文的目的是為耳科檢查處置和手術提供適當的防護建議。常規耳科手術應延期，緊急／急迫性手術必須在加強型全套個人防護裝備（PPE）下進行。一般防護措施包括佩戴PPE套件（N95口罩，動力濾淨式呼吸防護具，雙層手套、護目鏡、面罩、長袍、鞋套）、使用負壓室並減少必要人員的出勤。本文回顧使用高速器械儀器的乳突手術和遠程聽力檢查評估聽力安全防護問題的相關文獻。希望全國能遵守安全建議，共同安然度過疫情。

關鍵字

COVID-19 ； otology ； SARSCoV-2 ； surgery ； tele-audiometry（2019新型冠狀病毒肺炎；耳科學；嚴重急性呼吸道症候群冠狀病毒2型；手術；遠端聽力檢查）

並列摘要

The COVID-19 pandemic has overwhelmed the world since the end of 2019. Previous studies reported the presence of coronaviruses in the middle ear and mastoid, suggesting a risk of infection to medical staff during ear surgery in which aerosolizing procedures are commonly used. Therefore, there is a high risk of significant aerosol spread of COVID-19 pathogens from upper respiratory tract due to its continuity with middle ear when performing many otologic procedures. The aim of this study is to provide proper safety protocols for otologic practice and surgery. Elective otologic procedures should be postponed and emergent or urgent surgery must be carried out under reinforced personal protective equipment (PPE). General protective measures like wearing PPE kit (N95 mask, powered air-purifying respirators, double gloves, eye protection, face shield, gown, shoe cover), using negative pressure room and reducing personnel attendance to the essential were recommended. Issues regarding safety precautions while using high speed instruments during mastoid surgery and tele-audiometry for remote hearing evaluation were also reviewed. Sincerely hope that medical practitioners could all adhere to the safety suggestions and go through the pandemic together.

並列關鍵字

COVID-19 ； otology ； SARSCoV-2 ； surgery ； tele-audiometry

國際替代計量

COVID-19社區感染嚴重時期的耳科檢查處置與手術建議

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