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. 2020 Apr 23;137(3):161–166. doi: 10.1016/j.anorl.2020.04.012

Table 2.

Otologic and otoneurologic surgery: best practice advice in relation to the COVID-19 pandemic (adapted to take account of [9]).

Otologic surgery
Group Pathology or type of procedure Recommended approach
Group A
 Surgery that cannot be postponed Complicated otomastoiditis (lateral sinus thrombophlebitis, neuromeningeal damage, facial paralysis, temporomandibular arthritis, etc.)
Osteo-meningeal breacha
Cochlear implant for fibrosing labyrinthitis
Cholesteatoma with CSL fistula and associated symptoms that rule out surgery
Emergency treatment
Group B
 Risk of prognostic impact if treatment delayed for more than a month Middle ear cholesteatoma with mildly symptomatic CSL fistula
Osteo-meningeal breacha
Postpone surgery
Reassess the patient after 1 month and adapt the treatment programme according to the course of the disease and the spread of the COVID-19 pandemic
Group C
 No prognostic impact if treatment delayed for a minimum of 6 to 8 weeks
Tympanoplasty for uncomplicated cholesteatomas, tympanic retraction pockets, perforated eardrums, grommet insertion, ossiculoplasty, ear implant
Postpone surgery
Reassess the patient after 6 to 8 weeks and adapt the treatment programme according to the course of the disease and the spread of the COVID-19 pandemic
Otoneurologic surgery
Group Pathology or type of procedure Recommended approach
Group A
 Surgery that cannot be postponed Serious head injury in ENT-Neurosurgical joint team
Malignant tumour of the temporal bone and the cerebellopontine angle (CPA)
Benign tumour of the CPA with IH or fast-growing or sudden-onset functional deficit (visual problems, hemiplegia, paraplegia, etc.)
Immediate treatment
For poorly-tolerated benign tumours of the CPA, a ventriculoperitoneal shunt is usually preferred to excision of the tumour
Group B
 Risk of prognostic impact if treatment delayed for more than a month All other cases Postpone surgery
Reassess the patient after 1 month and adapt the treatment programme according to the course of the disease and the spread of the COVID-19 pandemic
a

Degree of urgency to be discussed on a case-by-case basis.