Read my lips: Clear versus standard masks during awake deep brain stimulation surgery – A randomized clinical trial

<h2>Abstract</h2><h3>Background</h3> We sought to determine if using clear masks in the operating room improves communication for patients undergoing awake deep brain stimulation (DBS) surgery. <h3>Methods</h3> This randomized, controlled study involved patients undergoing awake DBS receiving communication from the neurologist wearing a covered or clear mask for the intraoperative assessment, using a block randomization schedule. Adult patients (>18) undergoing DBS surgery between November 2021 and July 2023 were evaluated for inclusion. The primary outcome was a dichotomized response to the first question of a 10-question survey: "Did this provider explain things in a way that was easy to understand?", answered using a Likert scale of 1–4. Secondary outcomes included differences in the responses to the remaining questions. <h3>Results</h3> 104 patients were assessed for eligibility, 72 were enrolled, and 65 completed all questionnaires. More males than females (72.3 % versus 27.7 %) were enrolled, and most patients (64 %) underwent DBS for treatment of Parkinson's disease. The primary outcome analysis showed 93.5 % positive response in the clear mask group compared to 85.3 % in the covered mask group (p = 0.502). There were no infections within 30 days or study-related adverse events in either population. <h3>Discussion</h3> This randomized controlled trial demonstrates that the use of clear masks in the setting of awake brain surgery has no difference on patient perception of communication compared to covered masks. There were no infections or mask-related adverse events. This suggests that clear masks are a safe and effective alternative to traditional masks in the operating room.