Paik CB, Kim C, Nurimba M, Castellanos CX, Martinez E, Kokot N, Kwon D, Swanson MS and Sinha UK
Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, USAFulltext PDF
Objectives: Since the onset of the COVID-19 pandemic, institutional guidelines have suggested postponing non-emergent surgical cases to prevent nosocomial spread of the SARS-CoV-2 virus. However, it is well established that delays in Head and Neck Cancer (HNC) treatment are associated with increased morbidity and mortality. Current data on outcomes of major surgeries for HNC during the pandemic is limited. To address this, we compared the clinical and surgical outcomes of these surgeries performed during the pandemic to those prior to the pandemic. Materials and Methods: This is a retrospective cohort study, with the post-COVID cohort consisting of all HNC patients who underwent major surgeries including free flap reconstruction from March 11th, 2020 to December 21st, 2020, and the pre-COVID cohort including HNC patients who had similar surgeries from March 11th, 2019 to December 21st, 2019. A chart review was conducted for data regarding patient demographics, comorbidities, and clinical and surgical outcomes. Statistical analysis was done using Welch’s t-test of unequal variance and Fisher’s exact test. Result: There were no significant differences in treatment delays, hospital stays, surgery duration, Estimated Blood Loss (EBL), postoperative complications, and 30-day mortality between the two cohorts. However, readmission rates were significantly reduced and ICU stays were longer for postCOVID patients. Conclusion: Surgical treatment for HNC patients requiring free flap reconstruction can continue during the pandemic. With necessary precautions in place, surgeons may operate on HNC patients in a timely manner while maintaining clinical and surgical outcomes comparable to those prior to the pandemic
COVID-19; Head and neck cancer; Free flap reconstruction; Pandemic; outcomes; Level of Evidence: II
Paik CB, Kim C, Nurimba M, Castellanos CX, Martinez E, Kokot N, et al. Outcomes of Microvascular Reconstruction for Head and Neck Cancer in a COVID-19 Hot Spot. Ann Clin Otolaryngol. 2021; 6(1): 1050.