Begin with baseline airway evaluation to rule out risk of aspiration and/or the likelihood of becoming “at risk” for airway obstruction12. Nutritional status should also be evaluated, such as the patient’s ability to feed by mouth versus being nasogastric/PEG-dependent.
· Early disease
o Proceed with non-surgical treatment
o Consider deferral with close-interval telemedicine visits
· Intermediate disease
o Proceed with non-surgical treatment
· Advanced disease
o Proceed with non-surgical treatment where appropriate
o Primary surgery for patients presenting with advanced cartilage invasion, extra-laryngeal spread, recurrent disease, or high risk for aspiration post chemoradiation therapy
o Favor neo-adjuvant systemic therapy if surgery is indicated to allow deferral past peak incidence of pandemic