Impact of delay of elective otologic surgical interventions during the COVID-19 pandemic

Abstract

Objective: During the COVID-19 pandemic, many non-urgent elective otologic surgeries were postponed. Although it was generally for patients with slowly progressing benign pathologies, they could experience symptoms that vary in severity and impact on daily life and well-being. Furthermore, symptom severity and impact could evolve during the waiting period and may weigh differently in the unseen period of lockdown with little prospect of a rescheduled surgery. Although there is literature on surgery prioritization, patients have been insufficiently solicited. In this study, we aimed to gain a better understanding of patients’ subjective experience of complaints and their evolution and to incorporate this knowledge in future clinical decision-making with respect to postponement of elective care, in addition to a purely medical indication. Methods: An online survey was sent to 44 adult patients, diagnosed with benign ear pathology for whom surgery was cancelled owing to COVID-19 measures. The questionnaire was largely based on the Otology Questionnaire Amsterdam (OQUA), a validated generic questionnaire for scoring the severity and impact of symptoms and was supplemented by questions on evolution of symptoms and impact during lockdown. Results: Results from 32 patients were obtained. The majority of patients did not experience changes in symptom severity or impact on general well-being. Complaints of pain, pressure, and hearing loss increased the most over time. Conclusion: The most important parameters in assessing a new surgical planning order appear to be the severity score of the patients’ primary complaint and OQUA impact score. Waiting time and onset of complaints seemed to be rather questionable determinants.