Head and neck surgery during the coronavirus-19 pandemic: The University of California San Francisco experience

Head Neck. 2021 Feb;43(2):622-629. doi: 10.1002/hed.26514. Epub 2020 Oct 23.

Abstract

Background: Guidelines regarding head and neck surgical care have evolved during the coronavirus-19 (COVID-19) pandemic. Data on operative management have been limited.

Methods: We compared two cohorts of patients undergoing head and neck or reconstructive surgery between March 16, 2019 and April 16, 2019 (pre-COVID-19) and March 16, 2020 and April 16, 2020 (COVID-19) at an academic center. Perioperative, intraoperative, and postoperative outcomes were recorded.

Results: There were 63 operations during COVID-19 and 84 operations during pre-COVID-19. During COVID-19, a smaller proportion of patients had benign pathology (12% vs 20%, respectively) and underwent thyroid procedures (2% vs 23%) while a greater proportion of patients underwent microvascular reconstruction±ablation (24% vs 12%,). Operative times increased, especially among patients undergoing microvascular reconstruction±ablation (687 ± 112 vs 596 ± 91 minutes, P = .04). Complication rates and length of stay were similar.

Conclusions: During COVID-19, perioperative outcomes were similar, operative time increased, and there were no recorded transmissions to staff or patients. Continued surgical management of head and neck cancer patients can be provided safely.

Keywords: COVID-19; cancer; head and neck; perioperative care; surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • COVID-19*
  • Databases, Factual
  • Female
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection / statistics & numerical data
  • Operative Time
  • Otorhinolaryngologic Surgical Procedures / statistics & numerical data*
  • Parotid Gland / surgery
  • Plastic Surgery Procedures / statistics & numerical data*
  • Retrospective Studies
  • San Francisco
  • Thyroidectomy / statistics & numerical data
  • Treatment Outcome