CSO (Canadian Society of Otolaryngology - Head & Neck Surgery) position paper on rhinologic and skull base surgery d
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(2020) 49:81
REVIEW
Open Access
CSO (Canadian Society of Otolaryngology Head & Neck Surgery) position paper on rhinologic and skull base surgery during the COVID-19 pandemic Yvonne Chan1* , Sarfaraz M. Banglawala1, Christopher J. Chin2, David W. J. Côté3, Dustin Dalgorf1, John R. de Almeida1, Martin Desrosiers4, Richard M. Gall5, Artur Gevorgyan1, A. Hassan Hassan6, Arif Janjua7, John M. Lee1, Randy M. Leung1, Bradford D. Mechor8, Dominik Mertz9, Eric Monteiro1, Smriti Nayan10, Brian Rotenberg11, John Scott12, Kristine A. Smith5, Doron D. Sommer10, Leigh Sowerby11, Marc A. Tewfik13, Andrew Thamboo7, Allan Vescan1 and Ian J. Witterick1
Abstract Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset in the end of 2019. Amongst the most impacted are the elective medical and surgical services in order to conserve resources to care for COVID-19 patients. As the number of infected patients decrease across Canada, elective surgeries are being restarted in a staged manner. Since Otolaryngologists – Head & Neck Surgeons manage surgical diseases of the upper aerodigestive tract where the highest viral load reside, it is imperative that these surgeries resume in a safe manner. The aim of this document is to compile the current best evidence available and provide expert consensus on the safe restart of rhinologic and skull base surgeries while discussing the pre-operative, intra-operative, and post-operative care and tips. Risk assessment, patient selection, case triage, and pre-operative COVID-19 testing will be analyzed and discussed. These guidelines will also consider the optimal use of personal protective equipment for specific cases, general and specific operative room precautions, and practical tips of intra-operative maneuvers to optimize patient and provider safety. Given that the literature surrounding COVID-19 is rapidly evolving, these recommendations will serve to start our specialty back into elective rhinologic surgeries over the next months and they may change as we learn more about this disease.
Introduction and rationale As the case numbers of COVID-19 have increased worldwide, it has become more apparent that the elevated viral load in the upper aerodigestive tract mucosa not only affects skull base surgery but essentially all * Correspondence: [email protected] 1 Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada Full list of author information is available at the end of the article
diagnostic and therapeutic intranasal procedures that are routinely part of the scope of practice for Otolaryngologist - Head and Neck Surgeons [1]. A literature review of the current evidence regarding rhinologic surgery yielded several national position statements and recommendations. These were primarily composed of consensus expert opinion based on relatively small series as well as application from experiences with other similar diseases. The aim of this document is to summarize the current ev
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