Commentary on the management of total laryngectomy patients during the <scp>COVID</scp>‐19 pandemic

Hennessy, Max; Bann, Darrin V.; Patel, Vijay A.; Saadi, Robert; Krempl, Greg A.; Deschler, Daniel G.; Goyal, Neerav; Choi, Karen Y.

doi:10.1002/hed.26183

Cited by 30 publications

(121 citation statements)

References 21 publications

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“…36 Alternatives, such as CT, ultrasound, and X-ray, should be considered for other cases, depending on the diagnostic hypothesis. 22,36 An aspect of remarkable relevance is the PPE that should be used. Chan et al published the Hong Kong recommendations regarding PPE use.…”

Section: Endoscopic Examinationsmentioning

confidence: 99%

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Hojaij

Chinelatto

Boog

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Head and neck specialists and otorhinolaryngologists are greatly exposed to coronavirus disease 2019 (COVID-19) transmission in their everyday praxis. Many articles are being published regarding medical staff protection and patient management during the pandemic. Objective To provide an easy access to and a trustful review of the main aspects that have changed in the head and neck surgery and otorhinolaryngology practice due to the COVID-19 pandemic. Data Synthesis The search terms used were: (head and neck or otorhinolaryngology or ORL or thyroid) AND (severe acute respiratory syndrome coronavirus 2 [SARS-COV-2] or COVID-19 or CORONAVIRUS). The results were limited to the year of 2020. Articles were read in English, Portuguese, French, German, and Spanish or translated from Chinese. All included articles were read by at least two authors. Thirty-five articles were included. Most articles suggest postponing elective surgeries, with exception to cancer surgeries, which should be evaluated separately. Twenty-five articles recommended some kind of screening prior to surgery, using polymerase chain reaction (PCR) tests and epidemiological data. Extra precautions, such as use of personal protective equipment (PPE), are suggested for both tracheostomies and endoscopies. Fifteen articles give recommendation on how to use telemedicine. Conclusion The use of PPE (N95 or powered air-purifying respirator [PAPR]) during procedures should be mandatory. Patients should be evaluated about their COVID-19 status before hospital admission. Cancer should be treated. Tracheostomy tube cuff should be inflated inside the tracheal incision. All COVID-19 precautions should be kept until there is a validated antiviral treatment or an available vaccine.

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Section: Endoscopic Examinationsmentioning

confidence: 99%

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Hojaij

Chinelatto

Boog

et al. 2020

Int Arch Otorhinolaryngol

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“…These published papers and web-based statements contain precise recommendations for the performance of certain surgical procedures (e.g., tracheostomies) [9][10][11][12][13][14][15][16][17]. Others provide general protection advice for ORLs [18][19][20][21][22][23][24][25][26][27] or similarly atrisk disciplines [28,29]. Out of an abundance of caution, some otorhinolaryngological procedures like anterior rhinoscopy or the use of rigid or flexible endoscopes [30][31][32][33] were advised to be avoided unless absolutely necessary.…”

Section: Introductionmentioning

confidence: 99%

Results of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany

Herzog

Beule

Lüers

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose SARS-CoV-2 is detected on the mucosa of the upper airways to a high degree. In the course of the COVID-19 pandemic, otorhinolaryngologists (ORL) are assumed to be at high risk due to close contact with the mucosa of the upper airways. No data are yet available providing evidence that ORLs have an increased risk of infection. Methods German ORLs were invited via e-mail through the German Society of ORL, Head and Neck Surgery and the German ENT Association to participate in a web-based survey about infection with SARS-CoV-2 and development of COVID-19. Data of infections and concomitant parameters in German ORLs were collected and compared to the total number of infections in Germany. Results Out of 6383 German ORLs, 970 (15%) participated. 54 ORLs reported testing positive for SARS-CoV-2. Compared to the total population of Germany, ORLs have a relative risk of 3.67 (95% CI 2.82; 4.79) of contracting SARS-CoV-2. Domestic quarantine was conducted in 96.3% of cases. Two individuals were admitted to hospital without intensive care. No casualties were reported. In 31 cases, the source of infection was not identifiable whereas 23 had a clear medical aetiology: infected patients: n = 5, 9.26%; medical staff: n = 13, 14.1%. 9.26% (n = 5) of the identified cases were related to contact to infected family members (n = 3), closer neighbourhood (n = 1) or general public (n = 1). There was no identified increased risk of infection due to performing surgery. Conclusion German ORLs have an almost 3.7-fold risk of contracting SARS-CoV-2 compared to the population baseline level. Appropriate protection appears to be necessary for this occupational group.

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“…Study characteristics are summarized in Table 1. 3,[19][20][21][22] When searching the websites of professional organizations, we found that 3 had produced relevant guidance documents. [13][14][15] Following data extraction and synthesis, the results were categorized according to practice domains for tracheostomy and laryngectomy.…”

Section: Results and Observationsmentioning

confidence: 99%

“…The main recommendations according to each practice area are shown in Table 2. 3,13,14,[19][20][21][22][23][24][25]…”

Section: Results and Observationsmentioning

confidence: 99%

“…Adequate management of swallowing and communication difficulties in patients with laryngectomy is important to increase the quality of life of this highly vulnerable population in the current context of the pandemic. In this review, the relevant domains of practice throughout the literature were related to the management of breathing, 3,22,25 pulmonary aspiration, 3,13,14,22,25 and laryngeal voice. 3,13,14,25…”

Section: Assessment and Treatment Of Laryngectomymentioning

confidence: 99%

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Swallowing and Communication Management of Tracheostomy and Laryngectomy in the Context of COVID-19

Vergara

Starmer

Wallace

et al. 2021

JAMA Otolaryngol Head Neck Surg

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e are in the midst of a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). Management of patients with surgically modified airways, such as tracheostomy and laryngectomy, is challenging for the health care team in this novel context. Although there are few studies detailing infection rates and level of risk in the management, 1 those with tracheostomy and laryngectomy represent a potential transmission and infection risk for health care professionals 2,3 owing to the high viral load present in the upper aerodigestive tract. 4-6 Several professional organizations worldwide have published guidelines on the management of these patients for otorhinolaryngologists and head and neck surgeons. 7 Urgent and essential care provision is still required for these patients during the current pandemic, 8 and many more patients are requiring tracheostomy insertion as part of their recovery from severe COVID-19. 9 Multidisciplinary teams involved in the treatment of patients with tracheostomy or laryngectomy often include allied health professionals, such as speech-language pathologists (SLPs), who are responsible for the therapeutic restoration of swallowing and communication. 10,11 Speech-language pathologists are routinely involved with stoma and voice prosthe-sis care procedures and may perform suctioning of the lower airways. The objective of this study is to review and synthesize the literature regarding tracheostomy and laryngectomy management in the context of the COVID-19 pandemic to inform best practice and provide guidance for SLPs and the multidisciplinary team managing care for this population. Methods Using elements from a rapid review approach, 12 a comprehensive search of a single database and guidance documents published by relevant professional societies/organizations was completed. Guidelines unrelated to those of the current pandemic were also considered for synthesis. Two searches were conducted simultaneously using the PubMed database on May 15, 2020, using descriptors relevant to our objective-specifically, (1) tracheostomy, COVID-19, and SARS-CoV-2 using the Boolean operator and; and (2) laryngectomy, COVID-19, and SARS-CoV-2, also using the Boolean operator and. Using the selection criteria, a single reviewer (J.V.) screened all titles and abstracts for possible inclusion. Those meeting the criteria were selected for a full-text IMPORTANCE The care of patients with a surgically modified airway, such as tracheostomy or laryngectomy, represents a challenge for speech-language pathologists (SLPs) in the context of the coronavirus disease 2019 (COVID-19) pandemic. The objective was to review available publications and practice guidelines on management of tracheostomy and laryngectomy in the context of COVID-19. This study performed a review and synthesis of information available in the PubMed database and from national SLP organizations across 6 countries. OBSERVATIONS From the search, 22 publications on tracheostomy and...

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Commentary on the management of total laryngectomy patients during the COVID‐19 pandemic

Cited by 30 publications

References 21 publications

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

Results of a national web-based survey on the SARS-CoV-2 infectious state of otorhinolaryngologists in Germany

Swallowing and Communication Management of Tracheostomy and Laryngectomy in the Context of COVID-19

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