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Thursday, April 9, 2020

Guidelines for head and neck care during COVID-19 pandemic

A special article just published by DrGivi and colleagues in JAMA Otolaryngology-Head & Neck Surgery, guidelines are presented for head and neck physical examination and surgical and non-surgical procedures during the coronavirus (COVID-19) pandemic.
Because head and neck examinations are considered high risk in patients with suspected or confirmed COVID-19, the authors developed recommendations for health care workers based on review of the literature and communication with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic.

The authors note that:
  • Non urgent appointments should be postponed to limit infection of patients or health care workers. This may include postponing appointments for patients with benign disease and for those undergoing routine surveillance after treatment for head and neck cancer.
  • Patients should be queried by telephone about new or concerning signs or symptoms that may indicate recurrence and/or pending issues, as well as symptoms suggestive of COVID-19.
  • In-person clinic visits should be offered to those at risk for significant negative outcomes without evaluation.
  • To maintain relationships with patients and support assessments that can be made without in-person examinations, the use of telephone, video, or telemedicine visits should be considered.
  • In-person examinations should be limited to patients who need a thorough head and neck examination. Detailed guidelines are provided for physical examinations and associated procedures.

The authors are hopeful that following carefully planned routines and procedures, it will be possible to provide excellent care and help protect the safety and health of health providers and patients.

A model created by the National Cancer Institute predicts that tens of thousands of excess cancer deaths will occur over the next decade as a result of missed screening, delays in diagnosis, and reductions in oncology treatment caused by the COVID-19 pandemic. It is important that patients continue to be screened and treated.

Endoscopic examination by an otolaryngologist