COVID-19 시대의 연하장애에 대한 두경부 수술
Head and Neck Surgery for Dysphagia in the COVID-19 Era
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Treatment of patients with dysphagia has become more complicated due to the worldwide COVID-19 pandemic. A surgical field involving the upper respiratory tract, and the aerosol-generating nature of the surgery implies a higher risk of infection transmission to the surgeon and operating theater (OT) staff. Thus, most guidelines released during the COVID-19 era recommend postponement of surgical treatment for these patients. The surgical treatment for dysphagia can be classified into procedures improving swallowing functions, procedures preventing aspiration, and tracheostomy to preserve the airways. Dysphagia surgeries that improve swallowing functions and prevent aspirations have a lower priority, and therefore, should be delayed until the risk of infection decreases. However, tracheostomy is considered a high priority regardless of the infection risk. As per our experience, a tracheostomy can be conducted safely following strict infection control measures, such as proper personal protective equipment, isolated surgical field, and sterilization of surgical equipment, etc. Other dysphagia surgeries may also be conducted safely if attempted under a strict protocol, although careful assessment of the patient status and the institutional situation should be carried out in advance.
Abstract
Treatment of patients with dysphagia has become more complicated due to the worldwide COVID-19 pandemic. A surgical field involving the upper respiratory tract, and the aerosol-generating nature of the surgery implies a higher risk of infection transmission to the surgeon and operating theater (OT) staff. Thus, most guidelines released during the COVID-19 era recommend postponement of surgical treatment for these patients. The surgical treatment for dysphagia can be classified into procedures improving swallowing functions, procedures preventing aspiration, and tracheostomy to preserve the airways. Dysphagia surgeries that improve swallowing functions and prevent aspirations have a lower priority, and therefore, should be delayed until the risk of infection decreases. However, tracheostomy is considered a high priority regardless of the infection risk. As per our experience, a tracheostomy can be conducted safely following strict infection control measures, such as proper personal protective equipment, isolated surgical field, and sterilization of surgical equipment, etc. Other dysphagia surgeries may also be conducted safely if attempted under a strict protocol, although careful assessment of the patient status and the institutional situation should be carried out in advance.
참고문헌 (18)
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