Treatment outcomes in patients with laryngotracheal lesions and compromised airway during and prior to the coronovirus disease 2019 pandemic: a tertiary institution's experience.

E Gombert,P Guilcher,K Sandu,L Pignataro,G Cantarella,A Ishii,F Gorostidi

doi:10.1017/s0022215121002140

Abstract

This study aimed to compare treatment outcomes in patients with laryngeal and tracheal stenosis treated during and prior to the coronavirus disease 2019 pandemic period. Patients treated for laryngotracheal lesions with impending airway compromise during the active pandemic period were matched with those treated for similar lesions in the preceding years in a monocentric tertiary hospital setting. During the pandemic period of 55 days, 31 patients underwent 47 procedures. Seven patients (2 children, 5 adults) had open airway surgery, and one had an operation-specific complication. Twenty-four patients (10 children, 14 adults) underwent 40 endoscopic interventions without any complications. Operation specific results during and prior to the pandemic were comparable. The management strategy in patients with laryngotracheal lesions and impending airway compromise should not be altered during periods of risk from coronavirus disease 2019. Avoiding a tracheostomy by performing primary corrective surgery or proceeding with a definitive decannulation would be beneficial in these patients to reduce the risk of contagion.

Highlights

Since the beginning of the year 2020, following the announcement of the novel coronavirus disease 19 (Covid-19) pandemic, the world has witnessed unprecedented events like global lockdowns, restrictions on international travel, closures of provincial borders and extreme measures of social distancing
There was a plethora of such publications, but they lacked clarity regarding the exact management of patients with severe laryngotracheal stenosis and similar cases who underwent operation just before the declaration of the pandemic
Our clinic is a quaternary clinic specialising in managing patients with compromised airways and complex laryngotracheal stenosis

Summary

Introduction

Since the beginning of the year 2020, following the announcement of the novel coronavirus disease 19 (Covid-19) pandemic, the world has witnessed unprecedented events like global lockdowns, restrictions on international travel, closures of provincial borders and extreme measures of social distancing. Our clinic is a quaternary clinic specialising in managing patients with compromised airways and complex laryngotracheal stenosis. In this commentary, we share our units’ experience in managing patients with laryngotracheal lesions and airway compromise during the Covid-19 pandemic. Instead of temporising the airway compromise by performing a tracheostomy as advocated by some authorities,[4,8] we opted for definitive treatment of the lesion, which was similar to our practice followed prior to the pandemic. We compare the surgical outcomes in patients who had complex laryngotracheal lesions treated during and prior to the pandemic period

Methods

Results

Conclusion