CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2020; 24(04): e518-e526
DOI: 10.1055/s-0040-1715506
Systematic Review
Special Article COVID-19

Head and Neck Practice in the COVID-19 Pandemics Today: A Rapid Systematic Review

1   Department of Surgery, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
2   Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
2   Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
2   Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
2   Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
2   Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
› Author Affiliations


Introduction Head and neck specialists and otorhinolaryngologists are greatly exposed to coronavirus disease 2019 (COVID-19) transmission in their everyday praxis. Many articles are being published regarding medical staff protection and patient management during the pandemic.

Objective To provide an easy access to and a trustful review of the main aspects that have changed in the head and neck surgery and otorhinolaryngology practice due to the COVID-19 pandemic.

Data Synthesis The search terms used were: (head and neck or otorhinolaryngology or ORL or thyroid) AND (severe acute respiratory syndrome coronavirus 2 [SARS-COV-2] or COVID-19 or CORONAVIRUS). The results were limited to the year of 2020. Articles were read in English, Portuguese, French, German, and Spanish or translated from Chinese. All included articles were read by at least two authors. Thirty-five articles were included. Most articles suggest postponing elective surgeries, with exception to cancer surgeries, which should be evaluated separately. Twenty-five articles recommended some kind of screening prior to surgery, using polymerase chain reaction (PCR) tests and epidemiological data. Extra precautions, such as use of personal protective equipment (PPE), are suggested for both tracheostomies and endoscopies. Fifteen articles give recommendation on how to use telemedicine.

Conclusion The use of PPE (N95 or powered air-purifying respirator [PAPR]) during procedures should be mandatory. Patients should be evaluated about their COVID-19 status before hospital admission. Cancer should be treated. Tracheostomy tube cuff should be inflated inside the tracheal incision. All COVID-19 precautions should be kept until there is a validated antiviral treatment or an available vaccine.

Publication History

Received: 03 June 2020

Accepted: 25 June 2020

Article published online:
30 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

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