Head & neck
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The 2019 Coronavirus Pandemic challenges the delivery of care for patients with head and neck cancer. An important aspect of this care has been the evolution of enhanced survivorship services, which include surveillance for recurring cancer and prevention of second primaries. The application of evidence-based approaches to the identification and management of treatment and tumor-related toxicities has embraced the use of validated patient-reported outcomes instruments, health promotion, and care coordination. In this manuscript, we describe how our multidisciplinary team of survivorship providers has accommodated to the need to provide patients with social distancing while acknowledging the importance of continued care during treatment and through the spectrum of survivorship.
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The coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis. The diagnostic and containment efforts for the disease have presented significant challenges for the global health-care community. ⋯ Oral health-care providers are at an elevated risk of exposure to COVID-19 due to their proximity to nasopharynx of patients, and the practice involving the use of aerosol-generating equipment. Here, we summarize the general guidelines for oral health-care specialists for prevention of nosocomial transmission of COVID-19, and provide specific recommendations for clinical care management.
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Multicenter Study Comparative Study
Tracheostomy intervention in intubated COVID positive patients: A survey of current clinical practice among ENT surgeons.
The COVID-19 pandemic has resulted in an unprecedented need for critical care intervention. Prolonged intubation and mechanical ventilation has resulted in the need for tracheostomy in some patients. The purpose of this international survey was to assess optimal timing, technique and outcome for this intervention. ⋯ The results of this brief survey suggest that tracheostomy is of benefit in selected patients. There was insufficient data to suggest improved outcomes with either percutaneous vs an open surgical technique.
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Coronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami Hospital System, COVID-19 cases have multiplied for 4 weeks and elective surgery has been suspended. ⋯ We describe the use of actively managed surgical triage to fairly balance our patient's health with public health concerns.
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Observational Study
Safe and effective management of tracheostomy in COVID-19 patients.
An increasing number of COVID-19 patients worldwide will probably need tracheostomy in an emergency or at the recovering stage of COVID-19. We explored the safe and effective management of tracheostomy in COVID-19 patients, to benefit patients and protect health care workers at the same time. ⋯ Comprehensive evaluation before tracheostomy, optimized procedures during tracheostomy, and special care after tracheostomy can make the tracheostomy safe and beneficial in COVID-19 patients.