Table 3.

Endonasal surgery: best practice advice in relation to the COVID-19 pandemic.

Group	Pathology or type of procedure	Recommended approach
Group A
Surgery that cannot be postponed	Sinusitis with complications (cavernous sinus thrombophlebitis, neuromeningeal damage) or on fragile terrain, invasive fungal sinusitis Complicated mucocoele (neurological or ophthalmic signs) Very displaced nasal fracture, foreign body in the nasal cavity Nosebleed not controlled by a balloon catheter when radioembolisation is not possible Osteo-meningeal breacha	Emergency treatment
Group B
Risk of prognostic impact if treatment delayed for more than a month	Inverted papillomas Allergic fungal sinusitis in immunosuppressed patients Mucocoele without compression 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
Surgery which can be postponed for a minimum of 6 to 8 weeks without significant prognostic impact	Nasosinusal polyposis Aspergillus sinusitis, oro-antral fistula Benign lesion to be removed via endonasal route Rhinoseptoplasty Dacryocystorhinostomy via endonasal route	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

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