Philippine Journal of Surgical Specialties Vol. 75, No. 1, January-June 2020, pp 121

A Friendly Reminder to Fellow ENTs and Residents

Author(s): Philippine Academy of Rhinology, a subspecialty group of the Philippine Society of Otolaryngology – Head & Neck Surgery

ENTs have one of the highest COVID-19 infection rates from patient exposure in China.

When doing any physical examination on patients, presume that all have COVID-19: please wear complete PPE (N95 mask, goggles or face shield, gown, gloves) if we cannot procure Powered Air Purifying Respirators (PAPRs).

If there is an absolute need for an endoscopic procedure, please decongest using cotton soaked with lidocaine and oxymetazoline and insert in the nostril with a bayonet. Please avoid the use of any sprays to prevent aerosolization of the virus. The nasal cavity has the highest amount of viral shedding that can last for 20-37days.

Sterilize instruments and equipment used during the procedure according to Infectious Disease protocol in your hospital. Discard all disposables properly.

If a patient comes in with anosmia, be aware that recent onset isolated anosmia is one of the possible presentations of COVID-19. Assume that this is what your patient has. Advise self-quarantine for this patient. Systemic steroids are not advisable for COVID-19, please do not prescribe for the meantime unless with other concomitant conditions such as head trauma or nasal polyps.

Key words: nasal cavity, anosmia