Is adenotonsillectomy safe in covid-19 era? Investigation of sars-cov2 in adenoid and tonsil tissues

Müderris, Togay; Aysel, Abdulhalim; Yiş, Reyhan; Müderris, Tuba; Öktem, İbrahim Mehmet Ali; Çorakçı, Onur

doi:10.1016/j.amjoto.2022.103458

Cited by 1 publication

(5 citation statements)

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“…All elective surgeries were inevitably halted for an indefinite period 7,8 . SARS-COV-2 concentrates in the throat and nose of symptomatic as well as asymptomatic patients 6,9 and replicates in the palatine tonsils 6 . This major reservoir of the virus is exposed and disrupted in Tonsillectomy and adenoidectomy (TnA), putting operating room staff at risk of virus inhalation 4 .…”

Section: Discussionmentioning

confidence: 99%

“…Surgical practice faced a major deterrent amidst the COVID-19 pandemic 4,5 which caused up to 4.2 million deaths globally by march 2022 6 . All elective surgeries were inevitably halted for an indefinite period 7,8 .…”

Section: Discussionmentioning

confidence: 99%

“…Despite it being only a simulation study, sufficient evidence of droplet splatter was detected, therefore the authors deduced that in practice there must be smaller droplets depositing on surfaces or remaining aerosolized for longer that could not be detected in this study 28 . Coronaviruses are transmitted via respiratory droplets 4,6,20 but owing to their small size of approximately 0.125μm 28 and SARS-COV-2 ranging between 60-140nm 29 it is highly probable that aerosols would increase airborne transmission risk of COVID-19 in surgical settings 28 .…”

Section: Risks Posed By Tonsillectomy In a Pandemicmentioning

confidence: 99%

“…New mitigation protocols required all surgical patients to be tested for the virus 48 hours before admission 4,6,32 , especially when surgeons would be in close contact with their oral or nasal cavities. However, initially, this was not easily possible as many low-income-to-middle-income countries (LMIC) like India did not have widespread availability of RT-PCR tests for COVID-19 detection 30 , and hence, the limited resources could not be spent on every surgical patient prophylactically.…”

Section: Prophylactic Sars-cov-2 Rt-pcr Testing and Its Limitationsmentioning

confidence: 99%

“…The RT-PCR requires a nasal swab from the patient, therefore, should be conducted with proper PPE 36 . If the patient has recovered from COVID-19 recently or tests positive for the virus before admission, tonsillectomy should be delayed for a minimum of four weeks because even with a negative RT-PCR, SARS-COV-2 is detectable in tonsils and detritus of the patient's specimen till 3 weeks after infection 6,36 .…”

Section: Making Tonsillectomy Safermentioning

confidence: 99%

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Revisiting Tonsillectomy Practices in the Light of the COVID-19 Pandemic

2023

PJMD

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With the onset of the COVID-19 outbreak, a limited healthcare force catered to an ever-increasing number of COVID-19 patients on top of non-COVID-19 patients. Over two years after the pandemic, it is evident that medical practice must adapt to COVID-19 to ensure the provision of undeterred, quality medical care. This review intends to re-evaluate the Tonsillectomy protocols that we employed during COVID-19 and explore ways in which we might improve the safety of this frequently performed surgery even after the pandemic. A decrease in the frequency of tonsillitis was observed as lockdown and strict social distancing protocols were followed. Thus, it is concluded that tonsillectomies may be deferred unless urgent and in the best interest of the patient and medical workforce. However, when surgery is necessary, new mitigation strategies, like preoperative COVID-19 screening, minimizing intra-operative staff, widespread use of personal protective equipment (PPE), negative pressure operating rooms, and reducing postoperative hospital stay need to be incorporated into the safety protocols of airway surgeries and minimize aerosolization such as using SES (smoke evacuation system) during surgery and TORS (trans-oral robotic surgery). This narrative review covers an extensive literature review of papers on PubMed, Google Scholar and Medline that highlight the impact of the Pandemic on the surgical practice in patients of recurrent tonsillitis since December 2019. Keywords: Tonsillitis; Tonsillectomy; COVID-19; SARS-COV-2; Health Policy; Surgical Policy.

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