What are the recommendations for performing nasal
endoscopy surgery in COVID-19 patients?
Diagnostic procedures involving upper airway manipulation, such as nasal
endoscopy, should be considered high risk for viral transmission. Before
clinical examination, it is recommended to question all patients about
contact with confirmed COVID-19 patients, fever, respiratory symptoms
and recent sudden loss of smell and/or taste. During nasal endoscopy,
distance between the endoscopist and patient can be maximized by using a
tower with a camera, screen and light source, rather than using an
eyepiece. Also, manipulations should be limited if possible,
(i.e. nasal inspection vs debridement with suction and/or
forceps). The use of local anesthetic sprays can be replaced by
alternatives such as soaked pledgets because atomized anesthesia can
aerosolize the virus.123 Given that the COVID-19
status of patients consulting the outpatient rhinology clinic is often
unknown and the risk of transmission through clinical procedures is
high, wearing adequate PPE is mandatory.108,124 For
all surgical cases, pre-operative screening of the COVID-19 status of
the patient is recommended to adapt the PPE accordingly. In case of an
emergency where COVID-19 screening would imply an unacceptable
time-delay, the patient should be considered as COVID-19 positive and
PPE used.123