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dc.contributor.authorCRANIAL Consortium
dc.date.accessioned2021-10-20T23:30:29Z
dc.date.available2021-10-20T23:30:29Z
dc.date.issued2021-05
dc.identifier.issn1878-8750
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/329688
dc.description.abstractBACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been raised regarding the increased risk of perioperative mortality for patients with COVID-19, and the transmission risk to healthcare workers, especially during endonasal neurosurgical operations. The Pituitary Society has produced recommendations to guide management during this era. We sought to assess contemporary neurosurgical practice and the effects of COVID-19. METHODS: A multicenter prospective observational cohort study was conducted at 12 tertiary neurosurgical units (United Kingdom and Ireland). Data were collected from March 23 to July 31, 2020, inclusive. The data points collected included patient demographics, preoperative COVID-19 test results, operative modifications, and 30-day COVID-19 infection rates. RESULTS: A total of 124 patients were included. Of the 124 patients, 116 (94%) had undergone COVID-19 testing preoperatively (transsphenoidal approach, 97 of 105 [92%]; expanded endoscopic endonasal approach, 19 of 19 [100%]). One patient (1 of 116 [0.9%]) had tested positive for COVID-19 preoperatively, requiring a delay in surgery until the infection had been confirmed as resolved. Other than transient diabetes insipidus, no other complications were reported for this patient. All operating room staff had worn at least level 2 personal protective equipment. Adaptations to surgical techniques included minimizing drilling, draping modifications, and the use of a nasal iodine wash. At 30 days postoperatively, no evidence of COVID-19 infection (symptoms or positive formal testing results) were found in our cohort and no mortality had occurred. CONCLUSIONS: Preoperative screening protocols and operative modifications have facilitated endonasal neurosurgery during the COVID-19 pandemic, with the Pituitary Society guidelines followed for most of these operations. We found no evidence of COVID-19 infection in our cohort and no mortality, supporting the use of risk mitigation strategies to continue endonasal neurosurgery in subsequent pandemic waves.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherElsevier BV
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectCRANIAL Consortium
dc.subjectSkull Base
dc.subjectNasal Cavity
dc.subjectHumans
dc.subjectCerebrospinal Fluid Rhinorrhea
dc.subjectPostoperative Complications
dc.subjectEndoscopy
dc.subjectMass Screening
dc.subjectNeurosurgical Procedures
dc.subjectCohort Studies
dc.subjectProspective Studies
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectChild
dc.subjectIreland
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.subjectPreoperative Period
dc.subjectPersonal Protective Equipment
dc.subjectUnited Kingdom
dc.subjectCOVID-19
dc.subjectCOVID-19 Testing
dc.titleCSF Rhinorrhea After Endonasal Intervention to the Skull Base (CRANIAL) - Part 2: Impact of COVID-19.
dc.typeArticle
prism.endingPagee1097
prism.publicationDate2021
prism.publicationNameWorld Neurosurg
prism.startingPagee1090
prism.volume149
dc.identifier.doi10.17863/CAM.77134
dcterms.dateAccepted2020-12-26
rioxxterms.versionofrecord10.1016/j.wneu.2020.12.169
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-05
dc.identifier.eissn1878-8769
rioxxterms.typeJournal Article/Review


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International