Guidelines for reprocessing nonlumened heat-sensitive ear/nose/throat endoscopes

Endoscopes have become an indispensable instrument in the daily activity of the ear/nose/throat (ENT) department, but their use has introduced potential health risks such as the transmission of infection. Over the years, scientific knowledge has been consolidated regarding the most appropriate ways for the correct disinfection, and numerous guidelines have been issued for both digestive and respiratory endoscopes, whereas to date specific references to ENT endoscopes do not exist. The diagnostic ENT endoscope does not generally have an operative channel; it is shorter and thinner and has a much more frequent usage, also in the outpatient setting. As a consequence, the guidelines for digestive or respiratory endoscopes are not always functional for the ENT department in that they do not take into account the dynamics or the intensity of the work performed therein. This article proposes: 1) to standardize the correct way to carry out the disinfection procedure of heat-sensitive nonlumened ENT endoscopes to reduce to a minimum the possibility of errors or oversights; and 2) to guarantee the disinfection within a limited time frame, appropriate for an ENT outpatient department. In the initial phase, the critical areas encountered in ENT endoscopy are determined. This is followed by an examination of the literature to identify existing guidelines for the reprocessing of endoscopes (mainly digestive and respiratory), with a view to establishing a common disinfection procedure for nonlumened ENT endoscopes. Finally, the new methods of disinfection developed specifically for the reprocessing of ENT endoscopes are examined and discussed.