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

Abstract

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.