Table 1.

Proposed safety recommendations in the literature for operative and ambulatory settings

Operative Setting	Ambulatory Setting
All patients should receive COVID-19 testing within 24–48 h before surgery. With the exception of emergencies, surgeries should not proceed without confirmation of COVID-19 status.	Previsit screening questionnaires 24–48 h prior with COVID-19 testing for AGPs. Day-of symptom screening and temperature checks.
High-risk surgeries (all transoral and intranasal) should be performed under enhanced airborne precautions including gloves, gown, eye protection, and a minimum of an N95 respirator.	Maximum PPE should be worn during all potential AGPs including nasal endoscopy, injectables, noninvasive body contouring, and procedures involving lasers, light, and/or heat
Use of barriers such as nasal tents may limit potential viral spread.	Modifications in standard endoscopy technique include use of valved endoscopy of the nose and throat masks or back endoscopy approaches.
Continuous suctioning of the surgical field. Limit or avoid the use of high-powered drills with cutting burs, monopolar electrocautery, and power saws when possible.	Use of portable HEPA filters may be used as an adjunct for infection control but have not been tested specifically against SARS-CoV2.
PVP-I rinses at 1.25% and 2.5% for intranasal and intraoral use, respectively, may be safe however, in vivo efficacy against SARS-CoV2 is not well-established.	Use of topical medications on pledgets for nasal anesthesia and decongestion before nasal endoscopy is preferred over sprays, and may decrease irritative conditions resulting in aerosols.