Approach to otolaryngology emergency in COVID-19 pandemicBerkay Çaytemel, Halime Kılıç, Şenol Çomoğlu
Since the first case of novel coronavirus disease (COVID-19) was reported in China on December 31st, 2019, it spread almost all over the world rapidly and was declared pandemic by the World Health Organization (WHO) on March 11th, 2020. The first case in Turkey was also reported on the same day. COVID-19 is mainly transmitted through droplets and infected individuals may remain asymptomatic. As the reservoir of the virus is the upper respiratory tract, otolaryngology (ENT) examinations carry a high risk of infection to the physician and fever, sore throat, cough, shortness of breath and general illness, which are frequent COVID-19 symptoms, can be also seen in various ENT diseases. In case of severe upper respiratory obstruction, unstoppable nasal bleeding, or septal hematoma, which should be promptly intervened as ENT emergencies during the pandemic, patients should be accepted as COVID-19-positive and intervened accordingly. Thus, personal protective equipment (PPE) with eye protection/goggles, face shield, bonnet, disposable protective drape, and FFP3/N99 mask, if available and FF2/N95, if not must be used. In cases where the procedure can be postponed for some time, patients such as nasal fracture, and otitis-sinusitis complications should be requested polymerase chain reaction (PCR) for COVID-19 exclusion and thoracic section should be included in the computed tomography examination, if required. If possible, it is recommended to use powered air purifying respirators in surgical procedures to the upper respiratory tract. In case of sudden hearing loss and facial paralysis, systemic steroid therapy should be avoided due to its immunosuppressive effects.