'POLIDON' Approach-A Novel Solution for the ENT & Skull Base Surgeons in COVID-19 era

Health care providers (HCP) of ENT and Skull base surgery are highly vulnerable and mostly infected by novel coronavirus as they have to examine and perform procedures directly in oral cavity, oropharynx, nose, nasopharynx, where coronavirus remains in plenty. ENT & Skull base surgeons need to do several aerosol generating procedures (AGP). Most of the endoscopic and microscopic ENT & skull base surgery are AGP; like—mastoid surgery, sinus surgery, surgery of pituitary, tympanomastoid paraganglioma, temporal bone malignancy, tracheostomy etc. All of we know, COVID negative by RT—PCR test is not always COVID negative. In COVID-19 pandemic—routine, even cancer surgeries are avoided or postponed for the sake of safety of HCPs. Moreover, in case of surgical emergency there’s no way to refuse a patient for not having a report of COVID test. We thought about neutralizing or destroying the novel coronavirus from it’s route of entry zone, as well as preventing aerosol to be transmitted in the air of OT. We designed a novel approach, i.e. ‘POLIDON’ (POLIDON = Polythene + Povidone Iodine), which can be the solution for these patients as well as surgeons or HCPs of above mentioned specialties. Use of Povidone Iodine as mouthwash and nasal spray or irrigation for both patient and HCPs prior to surgery is proposed. Then, use of simple polythene as barrier drape of patient or operative area for prevention of spread of aerosol in OT during surgery is the other component. With the POLIDON’ approach—all these ENT & skull base surgeries can be done with more safety and confidence.