The CSO-HNS is collecting information from multiple sources to try to catalog the information in one place for use by members. The information is changing rapidly and we will endeavour to post information but cannot guarantee the accuracy of the information. Please use your clinical judgement in following any of these sources.

Monitor COVID-19 Case Trajectories World-wide – DASH BOARD


Personal Protective Equipment (PPE)

Guidance for Health Care Workers Performing Aerosol Generating Medical Procedures during the COVID-19 PandemicPDF document

N95 mask reprocessing from the The Netherlands National Institute for Public Health and the Environment – PDF document

N95 mask alternative from Boston’s Children’s

CDC recommendations on how to extend the life of N95 masks –

Stanford Covid-19 Town Hall (the entire 2+ hour video is useful, for some discussion of N95 and PAPR, go to approximately 1:06 to 1:14 hours on the timeline)    Available Streaming Online via ZOOM –

Download 480p (1.1 GB)

Personal Protective Measures in the Princess Margaret Head and Neck Cancer Clinic –

Michael Garron Hospital video on proper technique for taking PPE on and off –

Powered Air-Purifying Respirator (PAPR)

PAPRs are reusable respirators that are typically loose-fitting hooded or helmeted. They are equipped with a battery-powered blower to force air through a particle filter for the wearer to breath. They are capable of reducing airborne exposures at efficiencies that typically exceed the N95 and EHFR, using a high-efficiency particulate air filter (information from the Department of Health and Human Services, Centre for Disease Control and Prevention, United States).


CSO-HNS: Recommendations from the CSO-HNS Taskforce on Performance of Tracheotomy During the COVID-19 Pandemic – PDF document

United Kingdom: Guidance for Surgical Tracheostomy and Tracheostomy Tube Change During the COVID-19 Pandemic –

ENT UK Framework for Open Tracheostomy in COVID-19 Patients – PDF document

Wei WI et al. Safe tracheostomy for patients with severe acute respiratory syndrome*. Laryngoscope 2003:113;1777-9 –

*Three case reports during SARS in Hong Kong; the key points emphasized in doing the actual airway entry were paralyzing the patient with no ventilation occurring to avoid a “super spreader” event.

Sinus / Skull Base Surgery

Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic* (Standford University School of Medicine, Department of Otolaryngology-Head and Neck Surgery and Neurosurgery) – PDF document
*Please note:  The decision was made not to embargo this information given the urgent need to get this material out (to be published in Neurosurgery).

European Rhinologic Society –


Otologic Surgery

COVID-19 and Ear Surgery courtesy of R.K. Jackler, Stanford University – PDF document

Head & Neck Oncologic Surgery


  • AHNS COVID-19 Bulletin:  How COVID-19 is Affecting our Head and Neck Community – PDF document


  • Recommendations from the OHNS Department at University Health Network led by Ralph Gilbert in Toronto for head & neck oncologic procedures:  (1)  All procedures that include any instrumentation of the upper airway including the oral cavity and nasopharynx should be treated as high risk procedures and all staff in the operating room should be protected with PPE –  For nursing and surgical staff this includes N95 masks, eye protection, gowns and gloves.  Surgical staff may use loops if required for the surgical procedure.  (2)  All other procedures should be managed as per operating room standard.  (3)  Where possible we should work to minimize the number staff in the room during the aforementioned procedures, this includes residents and fellows who are not required for performance of the surgical procedure.  (4)  All patients that are scheduled for surgical procedures of the upper airway including the oral cavity will undergo COVID-19 screening 48hrs prior to the planned surgical procedure, should they test positive, their procedures will be deferred until screened negative.  (5)  COVID-19 screening can take place at a regional COVID-19 testing centre closest to the patient. (6)  For high risk procedures as defined above; the department recommends that oral cavity and nasal sites be separated from the remainder of the surgical sites for procedures such as neck dissection and parotidectomy. Techniques include the application of adhesive and sterile drapes.


  • Endocrine Surgery during the Covid-19 pandemic

The AHNS Endocrine Surgery Section  felt that it might be useful to have some guidance on endocrine  surgery cancellation given the Covid-19 pandemic. These are loosely adapted to those of the ESES.  These are just suggestions as to which patients may need to move forward with surgery now. The specific decisions would be in the context of local hospital and community resources, directives and importantly surgeon judgment.  The duration of postponement is not currently widely agreed upon.  Also with any patient being brought to the OR now or in the future given spread possible from intubation of asymptomatic  Covid -19 patients  all patients should be considered for COVID-19 testing 


  • Life-threatening  or severely symptomatic Graves’ that cannot be controlled medically
  • Goiter causing airway compromise with airway symptoms and tracheal narrowing
  • Thyroid cancers that are imminently threatening the life or the health of the patient such as those with short double timings or aggressive recurrences. 
  • Open biopsy to confirm a suspected diagnosis of anaplastic thyroid cancer or thyroid lymphoma in order to direct appropriate treatment.


  • HPT with life-threatening hypercalcemia that cannot be controlled medically

Pregnant patients:  

  • Endocrine disorders dangerous to the health of the mother or fetus that cannot be controlled medically

Brendan Stack AHNS Endocrine Surgery Section Vice Chair  

Greg Randolph AHNS Endocrine Surgery Section Chair  

Pediatric Otolaryngological Surgery

Message (March 23, 2020), President of the American Society of Pediatric Otolaryngology (ASPO) –

Experiences from Chinese Centres
Pandemic Guidelines

Pandemic Planning Clinical Guidelines for Patients with Cancer from Cancer Care Ontario courtesy of Jon Irish, University of Toronto – PDF document

Other Society Information Resources



Loss of smell as a marker of COVID-19

South Korea’s ‘Phone Booth’ Coronavirus Tests (South China Morning Post; March 19, 2020)

Self-Care and Stress Management During the COVID-19 Crisis PDF document

MD Financial Management’s summary of new financial measures, organized by their relevance to medical students and residents, practising physicians, retired physicians, and family members –


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