Bharat A. Panuganti, MD1*; John Pang, MD1*; Joseph Califano, MD1; Jason Y K Chan, FRCSEd (ORL)2.
1University of California-San Diego, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, San Diego, CA, USA.
2The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Shatin, Hong Kong.
Bharat A. Panuganti and John Pang are co-first authors.
Corresponding Authors:
Jason Y K Chan, FRCSEd (ORL)
2The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Shatin, Hong Kong
E-Mail: jasonchan@ent.cuhk.edu.hk
Joseph Califano
Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of
California–San Diego
3855 Health Sciences Dr, MC 0803, La Jolla, CA 92037-0803, USA.
Email: jcalifano@ucsd.edu
Running Title: Precautions and PPE in Head and Neck Surgery during COVID-19
Keywords: COVID-19, personal protective equipment, high-risk procedures, perioperative protocols
Abstract
Background: Otolaryngologists represent a subset of healthcare workers uniquely vulnerable to COVID-19 transmission. Given the segmentation of extant guidelines concerning precautions and protective equipment for SARS-CoV2, we aimed to provide consolidated recommendations regarding appropriate personal protective equipment (PPE) in head neck surgery during the COVID-19 era.
Methods: Guidelines published by international and United States governing bodies were reviewed in conjunction with published literature concerning COVID-19 transmission risk, testing, and PPE, to compile situation-specific recommendations for head and neck providers managing COVID-19 patients.
Results: High-quality data regarding the aerosolization potential of head and neck instrumentation and appropriate PPE during head and neck surgeries are lacking. However, extrapolation of recommendations by governing bodies suggest strongly that head and neck mucosal instrumentation warrants strict adherence to airborne-level precautions.
Conclusion: We present a series of situation-specific recommendations for PPE use and other procedural precautions for otolaryngology providers to consider in the COVID-19 era.