2.1 Standard precautions
Four studies report their experience of endonasal surgery during
COVID-19 with cumulative patient number of
305.12,25-27 Risk is mitigated through a combination
of pre-operative patient testing (with or without detail of subsequent
self-isolation for patients) and staff PPE use in the operating theatre,
with no added precautions unique to endonasal surgery. Though there were
subtle differences between each, all can be considered to reflect
variation in standard operating procedure between institutions. None
make specific measurements as to aerosolisation but patient and/or staff
infection levels are reported as an outcome of risk mitigation. Naik et
al. (2020)25 and the work from the CRANIAL Consortium
(2021)26 report no symptomatic COVID-19 infections in
patients at 14 and 30 days postoperatively, though no formal testing was
performed. Penner et al. (2020)12 and Taha et al.
(2020)27 tested staff and found no evidence of
COVID-19 infection during their case series. Taken as a whole, results
suggest that preoperative patient screening, to ensure patients are
COVID-19-negative, and PPE use is successful in mitigating risk, though
limitations apparent in these case series include lack of description as
to local level of endemic infection and so relative risk at each
institution, consistency in testing of patients and staff across studies
and possible unreported asymptomatic infections.