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COVID-19 and ENT Surgery - 17/05/20

Doi : 10.1016/j.anorl.2020.04.012 
V. Couloigner a, S. Schmerber b, R. Nicollas c, A. Coste d, e, B. Barry f, M. Makeieff g, P. Boudard h, E. Bequignon d, e, N. Morel i, E. Lescanne j,

French Society of Otorhinolaryngology, Head, Neck Surgery (SFORL)

French College of Otorhinolaryngology, Head, Neck Surgery

French Syndicate of ENT Specialists (SNORL)

a Paediatric ENT Department, Necker–Enfants Malades University Hospital, AP–HP, Paris, France 
b Department of Otorhinolaryngology, Head and Neck Surgery, Grenoble University Hospital, Grenoble, France 
c Paediatric ENT Department, Marseille University Hospital, AP–HM, Marseille, France 
d Department of Otorhinolaryngology, Head and Neck Surgery, Henri-Mondor University Hospitals, AP–HP, Tassigny, France 
e Department of Otorhinolaryngology, Head and Neck Surgery, Créteil Intercommunal University Hospital, AP–HP, Créteil, France 
f Department of Otorhinolaryngology, Head and Neck Surgery, Bichat University Hospital, AP–HP, Paris, France 
g Department of Otorhinolaryngology, Head and Neck Surgery, Reims University Hospital, Reims, France 
h ENT clinic, Bordeaux, France 
i ENT clinic, Échirolles, France 
j Department of Otorhinolaryngology, Head and Neck Surgery, Tours University Hospital, Tours, France 

Corresponding author at: Service d’ORL et de chirurgie cervico-faciale, 2, boulevard Tonnellé, 37000 Tours, France.Service d’ORL et de chirurgie cervico-faciale2, boulevard TonnelléTours37000France

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Abstract

In Otorhinolaryngology – Head and Neck Surgery, clinical examination and invasive procedures on the respiratory tract and on airway-connected cavities, such as paranasal sinuses and the middle ear, expose people to direct transmission of SARS-CoV-2 by inhalation or ocular projection of contaminated droplets, and to indirect transmission by contact with contaminated hands, objects or surfaces. Estimating an R0 of COVID-19 at around 3 justified postponing non-urgent face-to-face consultations and expanding the use of teleconsultation in order to limit the risks of SARS-CoV-2 infection of patients or health workers and comply with the lockdown. The health authority recommends cancellation of all medical or surgical activities, which are not urgent as long as this does not involve a loss of chance for the patient. The purpose of this cancellation is to significantly increase critical care capacity, prioritise the reception of patients with COVID-19, prioritise the allocation of staff and provision of the equipment necessary for their medical or surgical management, and contribute to the smooth running of downstream critical care within their establishment. Another goal is to reduce the risks of patient contamination within healthcare facilities. This document provides guidance on how to proceed with and adapt ENT surgery in the current pandemic context, as well as on the management of postponed operations. This best practice advice must of course be adapted in each region according to the development of the epidemic and pre-existing arrangements. Their local application can only be decided within the framework of collaboration between the ENT teams, the operational hygiene units and all the other specialties concerned.

El texto completo de este artículo está disponible en PDF.

Keywords : COVID-19, SARS-CoV-2, Personal protective equipment (PPE), Droplet-based transmission, Infectious disease


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Vol 137 - N° 3

P. 161-166 - mai 2020 Regresar al número
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