The role of local antiseptics in the prevention of coronavirus infection during endonasal interventions on the lacrimal ducts

Abstract

Generalization and analysis of available data concerning local antiseptic therapy for the prevention of coronavirus infection during endonasal interventions on the lacrimal tract. The search for literature sources was carried out using MEDLINE search engines and the Russian Science Citation Index for queries with the keywords "COVID-19", "coronavirus infection", "antiseptics", "protocol for otorhinolaryngological operations", "dacryosurgical operations" and similar in various combinations. It has been shown that during endonasal operations on the lacrimal tract, the number of risk factors for infection increases, since these procedures are aerosol-generating, and contact occurs not only with the nasal mucosa, but also with the lacrimal fluid, in which the coronavirus is also replicated. The data on the effectiveness of various antiseptics are summarized, the analysis of the possibility of their use in preoperative preparation for endonasal interventions on the lacrimal tract from the point of view of efficacy and safety is carried out. Information is provided on the proprietary protocol for the use of antiseptics to prevent the spread of coronavirus infection during endonasal dacryocystorhinostomy. It is shown that the preventive use of local disinfectants reduces the number of viral particles on the nasal mucosa, which leads to a decrease in contamination of the surrounding space. Among the available and studied antiseptics, the most suitable is povidone-iodine, which can be used in concentrations up to 1.25% to irrigate the nasal mucosa before surgery with an exposure of 30-60 sec. When performing operations on the lacrimal pathways, it is also advisable to carry out antiseptic treatment of the conjunctival cavity with a 5% solution of povidone-iodine and rinse the lacrimal pathways before the operation with povidone-iodine in a concentration of 0.4%. To date, information has been obtained that makes it advisable to use antiseptics before performing endonasal aerosol-generating interventions, in particular endonasal dacryocystorhinostomies and recanalization of the tear ducts.