Impact of  Coronavirus (COVID-19) on Otolaryngologic Surgery: A  Brief Commentary

Abstract

Background: The Coronavirus disease -2019 (COVID-19) pandemic is a global health crisis and Otolaryngologists are at increased occupational risk of contracting COVID-19. There are currently no uniform best-practice recommendations for Otolaryngologic surgery in the setting of COVID-19.Methods: We reviewed relevant publications and position statements regarding the management of Otolaryngology patients in the setting of COVID-19. Recommendations regarding clinical practice during the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) outbreaks were also reviewed.Results: Enhanced personal protective equipment (N95 respirator and face shield or powered air-purifying respirator, disposable cap and gown, gloves) is required for any Otolaryngology patient with unknown, suspected, or positive COVID-19 status. Elective procedures should be postponed indefinitely, and clinical practice should be limited to patients with urgent or emergent needs. Conclusion:We summarize current best-practice recommendations for Otolaryngologists to ensure safety for themselves, their clinical staff, and their patients.

Effect of the COVID-19 Pandemic on the Activity of Physicians Working in the Areas of Head and Neck Surgery and Otorhinolaryngology

“…25 Therefore, for initial (T1/T2) laryngeal carcinoma, radiation therapy may be an appropriate alternative to the high-risk microlaryngeal surgery with CO2 laser during the pandemic. 26 On the other hand, trying to keep a COVID-free environment is a real concern for some hospitals. Screening for SARS-CoV-2 in the 48 h prior to the procedure, although with questionable sensitivity in asymptomatic patients, may help to identify unsuspected positive patients, whose procedure could be postponed.…”

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

“…Two articles also suggest using chemo and/or radiotherapy to mitigate surgery delay impacts, if this approach is already a validated option in the tumor of concern treatment. 19,20 Six articles mentioned how to specifically treat thyroid cancer. Three articles were from the United States of America, one from Italy, one from China, and one from France.…”

“…Some authors defend a guideline-based approach, 29,40,43 while others suggest evaluating each case individually. 19,20,23 There are also other aspects related to cancer treatment during the COVID-19 pandemic that should be noted. Concentrating treatment in non-COVID-19 care hospitals is advisable.…”

“…All patients should be checked for symptoms before entering the hospital, and procedures are only made after either a PCR test or a chest CT is done. 19,23,43 Treatment choice should take many factors into consideration, such as: patient hospital exposure, duration of treatment, complexity of treatment, and health care staff infection risk. 20,46 Evaluating more complex cases in multidisciplinary conferences is recommended, 19,40 as there is no simple guideline on how to best postpone treatment.…”

“…19,23,43 Treatment choice should take many factors into consideration, such as: patient hospital exposure, duration of treatment, complexity of treatment, and health care staff infection risk. 20,46 Evaluating more complex cases in multidisciplinary conferences is recommended, 19,40 as there is no simple guideline on how to best postpone treatment. 21 For instance, there was a report of an immunodeficient patient with tongue squamous cell carcinoma, in which case it was decided to keep track of the lesion size through photos and only operate after the pandemic.…”