Recovery of Elective Facial Plastic Surgery in the Post-Coronavirus Disease 2019 Era: Recommendations from the European Academy of Facial Plastic Surgery Task Force

Unadkat, Samit; Andrews, Peter; Bertossi, Dario; D’Souza, Alwyn; Joshi, Anil; Shandilya, M.; Saleh, Hesham

doi:10.1089/fpsam.2020.0258

Cited by 24 publications

(41 citation statements)

References 7 publications

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“…In the United Kingdom, nasal endoscopy is only considered a potential aerosol generating procedure (AGP) and guidelines are in place to ensure its safe use during the recovery phase. 17,18,19 Equally, the current airway objective tools could also be considered potential AGPs with an increased risk of virus transmission. NIPF requires both maximal exhalation and inhalation, whereas acoustic rhinometry and rhinomanometry involve instrumentation within the nose.…”

Section: Introductionmentioning

confidence: 99%

Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Kaura

Tan

et al. 2020

Laryngoscope Investig Oto

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Objectives: There is a need to develop a medical device which can accurately measure normal and abnormal nasal breathing which the patient can better understand in addition to being able to diagnose the cause for their nasal obstruction. The aim is to evaluate the accuracy of the nasal acoustic device (NAD) in diagnosing the common causes for nasal obstruction and diagnosing normal and abnormal (nasal obstruction) nasal breathing. Methods: This pilot study recruited 27 patients with allergic rhinitis (AR), chronic rhinosinusitis (CRS), and a deviated nasal septum (DNS) which represents the common causes for NO and 26 controls (with normal nasal breathing). Nasal breathing sounds were recorded by the NAD akin to two small stethoscopes placed over the left and right nasal ala. The novel outcome metrics for the NAD include inspiratory nasal acoustic score (INA) score, expiratory nasal acoustic (ENA) score and the inspiratory nasal obstruction balance index (NOBI). The change in acoustic score following decongestant is key in this diagnostic process. Results: Pre-decongestant ENA score was used to detect the presence of nasal obstruction in patients compared to controls, with a sensitivity of 0.81 (95% CI: 0.66-0.96) and a specificity of 0.77 (0.54-1.00). Post-decongestant percentage change in INA score was used to identify the presence of AR or CRS, with a sensitivity of 0.87 (0.69-1.00) and specificity of 0.72 (0.55-0.89) for AR; and a sensitivity of 0.92 (0.75-1.00) and specificity of 0.69 (0.52-0.86) for CRS. Post-decongestant inspiratory NOBI was used to identify DNS, with a sensitivity of 0.77 (0.59-0.95) and specificity of 0.94 (0.82-1.00).

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Section: Introductionmentioning

confidence: 99%

Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Kaura

Tan

et al. 2020

Laryngoscope Investig Oto

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“…Even with proper PPE, it is important to remember that cosmetic/aesthetic plastic surgeons are at an augmented risk of contracting COVID-19 due to the aerosolization of viral particles during rhinoplasty and nasal reconstruction (two very central procedures for this specialty with very high viral loads present in the oral and nasal mucosa) [5], or potentially during other head and neck surgeries. Individual physician demographics may also influence their decision to continue operating.…”

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confidence: 99%

“…For providers that choose to practice during this time, preoperative and postoperative consults and follow-up appointments can also be done via telemedicine through Zoom, FaceTime, MDLive, HealthApp, WebEx, etc. to reduce in-person patient-physician contact [5]. To optimize telemedicine postoperatively, dissolvable sutures and patient-led wound care should be utilized [9].…”

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confidence: 99%

“…Still, the physician is unable to conduct in-person physical exams and inspect postsurgical wounds and recovery progress. Health Insurance Portability and Accountability Act (HIPAA) compliance must also continue to be maintained [3,5,10]. Other factors to consider during telemedicine appointments include scheduling coordination between patient and physician, internet access, and equipment capable of video consultation [10].…”

mentioning

confidence: 99%

“…The most recent swab test should be least two days prior to the procedure, or a rapid test should be done the morning of surgery. Patients should also self-isolate for 7 days prior to the procedure [5]. Patients should be screened before their appointment (after their two negative COVID-19 tests) if after they have had any symptoms, received any sort of medical treatment in a hospital, been in high-risk environments like a cruise ship, or been around anyone presumed to have COVID-19 as well.…”

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confidence: 99%

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The Financial Impacts of the COVID-19 Crisis on the Practices of Cosmetic/Aesthetic Plastic Surgeons

2020

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The global pandemic of coronavirus 2019, or COVID-19, has undeniably impacted all facets of healthcare, affecting both its function and provision. Due to the cessation of all non-emergent surgical cases in the USA and worldwide, the professional lives and practices of many physicians have been negatively affected. However, among different physicians and specifically plastic surgeons, cosmetic/aesthetic plastic surgeons have been disproportionately affected by the COVID-19 pandemic as the majority of their cases are semi-elective and elective. The ability to perform semi-elective and elective cases is dependent on state and local authorities' regulations, and it is currently uncertain when the ban, if ever, will be completely lifted. Financial constraints on patients and their future inability to pay for these procedures due to the COVID-19-related economic recession are things to consider. Overall, the goal of this unprecedented time for cosmetic/aesthetic plastic surgeons is for their medical practices to survive, to conserve cash flow although income is low to none, and to maintain their personal finances. In this paper, the authors review the financial impacts of the current COVID-19 pandemic on the practices of cosmetic plastic surgeons in the USA and worldwide, along with some potential approaches to maintain their practices and financial livelihoods.

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Appropriateness for SARS-CoV-2 vaccination for otolaryngologist and head and neck surgeons in case of pregnancy, breastfeeding, or childbearing potential: Yo-IFOS and CEORL-HNS joint clinical consensus statement

Saibene

Allevi

Ayad

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose SARS-CoV-2 vaccines are a key step in fighting the pandemic. Nevertheless, their rapid development did not allow for testing among specific population subgroups such as pregnant and breastfeeding women, or elaborating specific guidelines for healthcare personnel working in high infection risk specialties, such as otolaryngology (ORL). This clinical consensus statement (CCS) aims to offer guidance for SARS-CoV-2 vaccination to this high-risk population based on the best evidence available. Methods A multidisciplinary international panel of 33 specialists judged statements through a two-round modified Delphi method survey. Statements were designed to encompass the following topics: risk of SARS-Cov-2 infection and use of protective equipment in ORL; SARS-Cov-2 infection and vaccines and respective risks for the mother/child dyad; and counseling for SARS-CoV-2 vaccination in pregnant, breastfeeding, or fertile healthcare workers (PBFHW). All ORL PBFHW were considered as the target audience. Results Of the 13 statements, 7 reached consensus or strong consensus, 2 reached no consensus, and 2 reached near-consensus. According to the statements with strong consensus otorhinolaryngologists—head and neck surgeons who are pregnant, breastfeeding, or with childbearing potential should have the opportunity to receive SARS-Cov-2 vaccination. Moreover, personal protective equipment (PPE) should still be used even after the vaccination. Conclusion Until prospective evaluations on these topics are available, ORL-HNS must be considered a high infection risk specialty. While the use of PPE remains pivotal, ORL PBFHW should be allowed access to SARS-CoV-2 vaccination provided they receive up-to-date information.

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Recovery of Elective Facial Plastic Surgery in the Post-Coronavirus Disease 2019 Era: Recommendations from the European Academy of Facial Plastic Surgery Task Force

Cited by 24 publications

References 7 publications

Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

The Financial Impacts of the COVID-19 Crisis on the Practices of Cosmetic/Aesthetic Plastic Surgeons

Appropriateness for SARS-CoV-2 vaccination for otolaryngologist and head and neck surgeons in case of pregnancy, breastfeeding, or childbearing potential: Yo-IFOS and CEORL-HNS joint clinical consensus statement

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