Larynx/Hypopharynx (high risk for viral aerosolization)
Begin with baseline airway evaluation to rule out risk of aspiration and/or the likelihood of becoming “at risk” for airway obstruction12. Nutritional status should also be evaluated, such as the patient’s ability to feed by mouth versus being nasogastric/PEG-dependent.
Sinonasal and Skull base (high risk for viral aerosolization)
All endoscopic sinus surgery/endoscopic endonasal approaches are considered high risk procedures for viral aerosolization13, therefore all routine nasal endoscopy and debridement for follow-up should deferred when possible. Patients with inflammatory disease or non-malignant tumors should be deferred. Alternative non-surgical interventions should be considered for patients with active malignancies requiring treatment.
Patients with unavoidable, emergent surgery (i.e. invasive fungal sinusitis, impending visual or neurological compromise): we recommend full PAPR equipment for all involved in the case and minimize nonessential personnel in the operating room (trainees, advanced practice providers, visitors, etc.).