Introduction
March 2020 marked both the first national lockdown in the United Kingdom
and the declaration of a global pandemic by the World Health
Organisation. As we pass the unhappy anniversary of this time, it
invites us to reflect upon the inescapable changes that coronavirus has
wrought upon ENT practice. A series of measures were put in place to
prevent health services being overwhelmed by COVID-19, initially
involving the cancellation of elective surgery across the country.
Whilst this primarily aimed to allow reallocation of resources, specific
concerns were also raised about the safety of healthcare professionals
during surgical procedures.1 Coronaviruses are around
0.125μm in size but are frequently carried in larger respiratory
droplets.2 Transmission is primarily through spread of
these droplets and this places those specialties with frequent exposure
to oronasal secretions at particularly high risk. Logical reasoning
suggests that instrumentation of the nasal cavity has the potential to
aerosol these droplets and small particles and so risk spread of
coronavirus infection during rhinological surgery.
In order that important clinical practice can continue, the last twelve
months have seen a host of institutions attempt to both quantify the
risk rhinological surgery presents and mitigate it, often through
implementing creative innovations. COVID-19 is truly a global pandemic
and ENT departments worldwide are all the in same position of needing to
continue with emergent and, where possible, elective work in a safe
manner. This article presents a systematic review of the literature
examining articles considering either the quantification of risk or
strategies to mitigate risk in the setting of rhinological
surgery.