<scp>COVID</scp>‐19 pandemic: Effects and evidence‐based recommendations for otolaryngology and head and neck surgery practice

Kowalski, Luiz Paulo; Sanábria, Álvaro; Ridge, John A.; Ng, Wai‐Tong; Bree, Remco de; Rinaldo, Alessandra; Takes, Robert P.; Mäkitie, Antti; Carvalho, André Lopes; Bradford, Carol R.; Paleri, Vinidh; Hartl, Dana M.; Poorten, Vincent Vander; Nixon, Iain J.; Piazza, Cesare; Lacy, Peter D.; Rodrigo, Juan P.; Guntinas‐Lichius, Orlando; Mendenhall, William M.; D’Cruz, Anil; Lee, Anne W.M.; Ferlito, Alfio

doi:10.1002/hed.26164

Cited by 274 publications

(360 citation statements)

References 41 publications

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“…[14][15][16][17][18] Particularly pertinent to otolaryngology is a heightened concern regarding the increased risk of COVID-19 transmission owing to the nature of the head and neck examination and common otolaryngologic procedures. 7,8 Furthermore, telehealth and distance care can be especially difficult among subsets of otolaryngology diseases, including head and neck cancers and airway disorders. 19 As the scope of otolaryngology practice is wide, ranging from benign pathologies (including hearing loss and sinusitis) to head and neck cancer, a shift in the quantity and modality of clinical visits is expected and encouraged.…”

Section: Discussionmentioning

confidence: 99%

“…Many institutions have fashioned and employed guidelines regarding triaging patient care conditioned on the acuity of the otolaryngologic condition. 7,8,10 Nevertheless, with a lack of complete understanding of COVID-19 and its impact, there is expected variability within these recommendations.…”

Section: Discussionmentioning

confidence: 99%

“…In light of this, there has been a widespread shift among otolaryngologists toward minimizing direct patient interaction in nonacute settings. 7,8 Several otolaryngology divisions and departments have documented their subjective response to this changing landscape, but little objective measurement on COVID-19's impact has been reported. 9,10 Herein, we discuss the affect that COVID-19 has had on our institution.…”

mentioning

confidence: 99%

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Outpatient Otolaryngology in the Era of COVID‐19: A Data‐Driven Analysis of Practice Patterns

Kasle

Torabi

Savoca

et al. 2020

Otolaryngol.--head neck surg.

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Introduction Coronavirus disease 2019 (COVID-19) has induced a prioritization of acute care and telehealth, affecting the quantity of patients seen and the modality of their care. Study Design Retrospective review. Setting Single-institution study conducted within the Division of Otolaryngology at the Yale School of Medicine. Subjects and Methods Data on all outpatient appointments within the Division of Otolaryngology were obtained from administrative records of billing and scheduling from March 16 to April 10, 2020. For comparison, a corresponding period from 2019 was also utilized. Results Of 5913 scheduled visits, 3665 (62.0%) were seen between March 18 and April 12, 2019, in comparison with 649 of 5044 (12.9%) during the corresponding COVID-19–affected period. The majority of completed visits performed in weeks 1 and 2 were in person, while the majority in weeks 3 and 4 were via telehealth. Among subspecialties, a larger proportion of completed visits in 2020 were performed by pediatric and head and neck oncology otolaryngologists as compared with general/specialty otolaryngologists ( P < .001). Older adults (≥65 years) were less likely to have telehealth visits than younger adults (18-64 years; 45.6% vs 59.6%, P = .003). Conclusions A major decrease in the completion rates of scheduled visits was seen in the COVID-19–affected period, though this was not proportional among subspecialties. An associated increase in telehealth visits was observed. After COVID-19–related hospital policy changes, approximately 2 weeks passed before telehealth visits surpassed in-person visits, though this was not true among older adults.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Outpatient Otolaryngology in the Era of COVID‐19: A Data‐Driven Analysis of Practice Patterns

Kasle

Torabi

Savoca

et al. 2020

Otolaryngol.--head neck surg.

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“…If the decision is made to operate, appropriate PPE, such as an N95 mask with a face shield and eye protection, is of utmost importance to protect the entire surgical team as well as the patient. 8,[13][14][15] Telemedicine appointments and photographic monitoring should be used whenever feasible in order to allow home isolation. Most importantly, we recommend an honest discussion of the situation with the patient, taking into account their comfort and goals of care.…”

Section: Discussionmentioning

confidence: 99%

“…11 Anecdotal reports from Wuhan, China, report higher rates of infection specifically among otolaryngologists. [12][13][14][15] Personal protective equipment (PPE) is a currently scarce but essential resource for the aerosolizing procedures performed by otolaryngologists.…”

Section: Introductionmentioning

confidence: 99%

Care of immunocompromised patients with head and neck cancer during the COVID‐19 pandemic: Two challenging and informative clinical cases

et al. 2020

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Background and Methods: There is an added level of complexity in the management of head and neck cancer patients with underlying immunosuppressive disorders during the COVID-19 pandemic. Head and neck oncologists are tasked with balancing the dual risks of cancer progression in the setting of impaired tumor immunity and increased susceptibility to life-threatening complications from exposure to viral infection for patients and providers. Through two cases of immunocompromised patients with newly diagnosed head and neck malignancies, we aim to provide guidance to clinicians struggling with how to best counsel and manage this unique subset of patients under these difficult circumstances. Results: After careful consideration of the options, we took different approaches in the care of these two patients. Conclusions: Ultimately, there is no uniform set of rules to apply to this heterogeneous group of immunocompromised patients. We provide some general principles to help guide patient management during the current pandemic.

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Skull‐base surgery during the COVID‐19 pandemic: the Italian Skull Base Society recommendations

Castelnuovo

Turri‐Zanoni

Karligkiotis

et al. 2020

Int Forum Allergy Rhinol

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Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 , is highly contagious with devastating impacts for healthcare systems worldwide.Medical staff are at high risk of viral contamination and it is imperative to know what personal protective equipment is appropriate for each situation. Furthermore, elective clinics and operations have been reduced in order to mobilize manpower to the acute specialties combatting the outbreak; appropriate differentiation between patients who require immediate care and those who can receive telephone consultation or whose treatment might viably be postponed is therefore crucial.Italy was one of the earliest and hardest-hit European countries and therefore the Italian Skull Base Society board has promulgated specific recommendations based on consensus best practices and the literature, where available. Only urgent surgical operations are recommended and all patients should be tested at least twice (on days 4 and 2 prior to surgery). For positive patients, procedures should be postponed until after swab test negativization. If the procedure is vital to the survival of the patient, FFP3 and/or PAPRs devices, goggles, full-face visor, double gloves, water-resistant gowns and protective caps, are mandatory. For negative patients, use of at least FFP2 mask is recommended. In all cases the use of drills, which promote the aerosolization of potentially infected mucous particles, should be avoided. Given the potential neurotropism of SARS-CoV-2, dura handling should be minimized. It is only through widely-agreed protocols and teamwork that we will be able to deal with the evolving and complex implications of this new pandemic.

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COVID‐19 pandemic: Effects and evidence‐based recommendations for otolaryngology and head and neck surgery practice

Cited by 274 publications

References 41 publications

Outpatient Otolaryngology in the Era of COVID‐19: A Data‐Driven Analysis of Practice Patterns

Outpatient Otolaryngology in the Era of COVID‐19: A Data‐Driven Analysis of Practice Patterns

Care of immunocompromised patients with head and neck cancer during the COVID‐19 pandemic: Two challenging and informative clinical cases

Skull‐base surgery during the COVID‐19 pandemic: the Italian Skull Base Society recommendations

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