Endoscopic Procedures in ENT and Aerosolization during Covid-19 Pandemic: An Approach towards Concepts and Guidelines

The present study aims to discuss different concepts and guidelines for endoscopic procedures and risk of aerosolization. Aerosols are more likely to be inhaled by otolaryngologists during routine ENT examinations and endoscopic procedures. ENT endoscopy procedures are regarded as the most aerosol-generating procedures, and routine procedures are preferably avoided and postponed if not absolutely necessary or urgent at this time of Covid-19 pandemic. The small particle size and extended travel of airborne aerosols mandate the use of specific PPE and barriers by the health care workers to protect against transmission of Covid-19. Studies have recommended ENT endoscopy in awake patients with adequate topical preparation of local anaesthesia. Use of sprays should be avoided, instead, carefully placed pledgets should be used to provide adequate decongestion and anesthesia. Wearing a N95 mask with face shield or full PPE, thorough cleaning of entire endoscope after removal by standard disinfectants, decontamination of endoscopy room after each procedure, and proper disposal of contaminated waste products are some common guidelines advised by health authorities worldwide to date. The information and advices regarding different diagnostic and treatment procedures from different authorities is subject to change depending on ongoing local situation and developments of Covid-19 pandemic and we should strictly follow the national and local guidelines issued by concerned authorities and keep us updated on latest advices available.