Covid-19 and Rhinoplasty

How can we get safely back to work?

One of our most urgent concerns today is how to manage rhinoplasty during the Covid pandemic and what are the arrangements that matter to return to the OR safely.

Objectives

Recommendations and Clinical Guidelines in Rhinoplasty during COVID-19 pandemic

Introductory lecture

C-19 PCR and Antibody test | Parham Sendi

Panelists

Mario Bussi | Nazim Çerkes | Charles East | Olivier Gerbault | Wolfgang Gubisch | Haug Martin | Werner Heppt | Haldun Kamburoğlu | Philio Lekakis | Enrico Robotti

Guests

in collaboration with TRS (The Rhinoplasty Society US) 

Jay Calvert USA | Sam Most USA | Rod Rohrich USA

Moderation

Martin Haug | Enrico Robotti

Organization

Martin Haug | Josef Vavrina

Program

20:00 Start and welcome (Enrico Robotti)

20:05-20:15 Prof Parham Sendi, lecture “C-19 PCR and Antibody test”.

20:15-20:23 Session 1: Protection during consultation with patients

Chair: Philio Lekakis

    • Separate COVID-19 area in private practice?
    • Which items work – masks, shields, air purifying systems, UV-C, disinfection?
    • How to use them?
    • Chest CT scan for screen or diagnosis?

20:23-20:30 Discussion, consensus conference with voting by expert panel, Q&A

20:30-20:40 Rod Rohrich “How do we handle this in Dallas and how the situation is seen and evolves in the US Plastic Surgery community”

20:40-20:50  Session 2: Patient assessment Pre-Op

Chair: Charles East

Patient selection, indication:        

    • Structured medical history: What are the key questions?
    • Which patients should not undergo surgery?
    • Which operations can/may/should be performed?
    • Operation indications? (elective is not elective)

Testing:        

    • How to avoid operating on undetected COVID-19 patients
    • Which PCR test?
    • Are Antibody-tests useful at the moment?

Timing:          

    • How many days/hours before operation?
    • Is quarantine necessary? Duration?

20:50-21:00 Discussion, consensus conference with voting by expert panel, Q&A

21:00-21:05 Sam Most “How do we handle this at Stanford and how the situation is seen and evolves in the US ENT community”

21:05-21:15 Session 3: Intra-Op

Chair: Werner Heppt, Olivier Gerbault

    • Is an antiseptic packing prior to surgery of any use to reduce the viral charge? 
    • Intranasal/pharynx disinfection? How and which products? 
    • Does laminar flow protect us? 
    • How to protect ourselves?
    • General anesthesia: Is there a difference? 
    • Aerosol in the OR: How to avoid production? 
    • Are there techniques/maneuvers to avoid? Power instruments ? Piezo? 
    • Nasal packing: How to handle? 

21:15-21:25 Discussion, consensus conference with voting by expert panel, Q&A

21:25-21:30 Mario Bussi “Italian ENT Society and other European ENT Societies good practice perspectives regarding rhinoplasty in the COVID-19 era”

21:30-21:40 Jay Calvert “Performing rhinoplasty safely during the COVID-19 pandemic: a perspective from The Rhinoplasty Society US”

21:40-21:45 Rod Rohrich “Medical rhinoplasty and fillers: How should we approach it?”

21:45-21:50 Sam Most “Surviving COVID-19, perspectives from the other side: as a patient”

21:50-22:00 Session 4: Legal aspects, problems

Chair: Haldun Kamburoglu

    • Does COVID-19 influence the rate of problems during surgery?
    • How can a rhinoplasty patient be infected (consultation, operation, follow-up) and in which circumstances is the surgeon responsible?
    • Is this a complication or malpractice?
    • What is the correct timing for resuming elective surgery? Is it worth to take the risk? What should be the threshold – corona virus positive cases number in your city to feel safe?
    • Do informed consent forms protect us?
    • If any risk occurs, does your insurance policy cover it?

22:00 Discussion, consensus conference with voting by expert panel, Q&A

Conclusions by Martin Haug, Enrico Robotti