Introduction
March 2020 marked both the first national lockdown in the United Kingdom and the declaration of a global pandemic by the World Health Organisation. As we pass the unhappy anniversary of this time, it invites us to reflect upon the inescapable changes that coronavirus has wrought upon ENT practice. A series of measures were put in place to prevent health services being overwhelmed by COVID-19, initially involving the cancellation of elective surgery across the country. Whilst this primarily aimed to allow reallocation of resources, specific concerns were also raised about the safety of healthcare professionals during surgical procedures.1 Coronaviruses are around 0.125μm in size but are frequently carried in larger respiratory droplets.2 Transmission is primarily through spread of these droplets and this places those specialties with frequent exposure to oronasal secretions at particularly high risk. Logical reasoning suggests that instrumentation of the nasal cavity has the potential to aerosol these droplets and small particles and so risk spread of coronavirus infection during rhinological surgery.
In order that important clinical practice can continue, the last twelve months have seen a host of institutions attempt to both quantify the risk rhinological surgery presents and mitigate it, often through implementing creative innovations. COVID-19 is truly a global pandemic and ENT departments worldwide are all the in same position of needing to continue with emergent and, where possible, elective work in a safe manner. This article presents a systematic review of the literature examining articles considering either the quantification of risk or strategies to mitigate risk in the setting of rhinological surgery.