Head and neck cancer surgery during the COVID-19 pandemic: the Chris O’Brien Lifehouse experience and narrative review

Abstract

Background: Head and neck cancer (HNC) treatment has been significantly affected worldwide by the SARS-Cov-2 pandemic due to high viral loads in the upper aerodigestive tract. We present a single-institution experience of successful continued management of HNC patients during the pandemic. Methods: A retrospective audit was conducted comparing operative time, anaesthetic time, case volume and type (aerosol generating vs. non aerosol generating) between equivalent time periods from 2019 and 2020 during the peak of the pandemic in Australia, from a single high-volume, tertiary, academic head and neck centre. Furthermore, we document the multi-level changes instituted for each department involved in the patient cancer journey. Results: The average operative time for aerosol generating procedures (AGPs) was 85 minutes (IQR 455) in March 2019 compared with 180 minutes in March 2020 (IQR 366). Case volume and case type was similar between the two years. With appropriate patient screening, perioperative planning and judicious use of personal protective equipment (PPE), higher-risk AGPs were able to continue essentially as normal. Conclusions: HNC requires timely investigation and treatment, even in the midst of a pandemic, which can be achieved at a dedicated, COVID-free oncology centre utilising clear, rapid communication and a multidisciplinary approach. © Australian Journal of Otolaryngology. All rights reserved.