Effects of Interruption of Care during COVID-19 Pandemic on Sinus and Skull Base Surgery Patients

Objective: Due to COVID-19, patients who had sinus or skull base surgery in February and early March 2020 were unable toreceive standard postoperative care. Currently, there is a lack of data on the short- and long-term impacts of this. Wesought to examine the effects of the interruption of care due to COVID-19 on sinus and skull base surgery patientoutcomes. Study Design: Retrospective chart review. Methods: A retrospective review was conducted examining outcomes and healthcare utilization of patients at our institutionwho underwent sinus or skull base surgery in February and March of 2020, and who experienced an interruption inpostoperative care due to the pandemic. We then compared these measures with those of patients from the same timeperiod in 2019, who did not experience an interruption in care. Patient characteristics including age, indication for surgery,extent of surgery, polyps, preoperative Lund-Mackay and sinonasal outcome (SNOT22) scores and history of prior sinus orskull base surgery were recorded. Study outcomes included 3 and 6 month postoperative SNOT22 and Modified Lund-Kennedy endoscopy scores, antibiotic usage, sinonasal debridements performed, and number of telephone calls andtelehealth visits in the postoperative period. Results: A total of 107 patients were included. Of the SNOT22 scores available, the average change between preoperativeand 3 month postoperative SNOT22 scores for 2020 ( n = 15) compared to 2019 patients ( n = 30) was not significantlydifferent (a decrease of 17.27 and 19.93, respectively;p = 0.68). The average change between preoperative and 6-monthpostoperative SNOT22 scores for 2020 ( n = 13) compared to 2019 patients ( n = 26) was also not significantly different (adecrease of 18.69 and 20.77, respectively;p = 0.75). The average number of oral postoperative antibiotics received did notsignificantly differ between 2020 ( n = 52) and 2019 ( n = 55) cohorts (0.18 vs. 0.09, respectively;p = 0.53). The averagenumber of postoperative telephone calls did not significantly differ between 2020 and 2019 patients (1.51 vs. 1.19;p = 0.95). Patients in 2019 received an average of 2.35 postoperative sinonasal debridements compared to 1.90 in 2020 ( p =0.03). The average number of postoperative telehealth visits for 2020 patients was 0.72. Of the 2020 patients, 50% werelost to follow-up at 3 months postoperatively compared to 18% in 2019 ( p = 0.0005) and 71% were lost to follow-up at 6months postoperatively in 2020 compared to 36% in 2019 ( p = 0.0003). Conclusion: Although there was an interruption in postoperative care due to COVID-19, patients in 2020 who returned forfollow-up 3 and 6 months after surgery did not report significantly different subjective sinonasal outcomes compared topatients in 2019. A significantly greater number of patients have been lost to follow-up in 2020 compared to 2019 and havenot received routine postoperative care. Further study is required to determine the impact of the interruption of care due toCOVID-19 on sinus and skull base surgery outcomes.