Safety practices for in‐office laryngology procedures during clinical reintroduction amidst COVID‐19

Abstract

Abstract Objective Describe safety practices for performing in‐office laryngology procedures during clinical re‐introduction amidst the coronavirus disease 2019 (COVID‐19) pandemic. Methods An anonymous survey in Qualtrics was created to evaluate demographics, preprocedure testing, practice settings, anesthesia, and personal protective equipment (PPE) use for five procedure categories (non‐mucosal‐traversing injections, mucosal‐traversing injections, endoscopy without suction, endoscopy with suction/mucosal intervention via working channel, and laser via working channel). The survey was emailed to the Fall Voice Community on Doc Matter and to members of the American Broncho‐Esophagological Association (ABEA) from May to June 2020. Results Eighty‐two respondents were analyzed (response rate: 10%). Respondents represented diverse locations, including international. Most reported academic (71%) or private practices (16%), laryngology fellowship training (76%), and a significant practice devotion to laryngology and broncho‐esophagology. During the early re‐introduction, most continued to perform all procedure categories. The office was preferred to the OR setting for most, though 36% preferred the OR for laser procedures. There was a preference for preprocedural SARS‐Cov2 testing for procedures involving a working channel (>67%), and these procedures had the highest proportion of respondents discontinuing the procedure due to COVID‐19. Various types of topical anesthesia were reported, including nebulizer treatments. The most common forms of personal protective equipment utilized were gloves (>95%) and N95 masks (>67%). Powered‐air purifying respirators and general surgical masks were used infrequently. Conclusions During the early re‐introduction, respondents reported generally continuing to perform office laryngology procedures, while greater mucosal manipulation affected decisions to stop procedures due to COVID‐19, perform preprocedural SARS‐Cov2 testing, and alter topical anesthesia. Gloves and N95 masks were the predominate PPE. Level of Evidence N/A.

Keywords

• coronavirus
• COVID‐19
• laryngoscopy
• otolaryngology
• personal protective equipment