Allevi et al. (2020)1111 Allevi F, Dionisio A, Baciliero U, Balercia P, Beltramini GA, Bertossi D, et al. Impact of COVID-19 epidemic on maxillofacial surgery in Italy. Br J Oral Maxillofac Surg. 2020;58:692–7.
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Cross-sectional survey |
32 oral and maxillofacial surgeons |
Most of maxillofacial surgery units have carried on the surgical management of facial trauma (74%) and head and neck oncology (90%). |
Nasopharyngeal swabs were performed mostly in symptomatic patients (43%), followed by already hospitalized patients (18%) and candidates for surgery (9%). FFP2/N95 masks were provided in 61% of maxillofacial departments. Disposable gloves and surgical masks were provided in 91% and in 100% of maxillofacial wards, respectively, while disposable gowns were supplied only in 39% of maxillofacial units. |
22% of maxillofacial units found infected surgeons (4% of maxillofacial surgeons), of different grades according to the intensity of contamination of the geographic areas. |
All maxillofacial activity was greatly reduced during the period of the COVID-19 epidemic: tumor surgery and trauma surgery were largely guaranteed, while other pathologies accumulated delays. |
Barca et al. (2020)1212 Barca I, Cordaro R, Kallaverja E, Ferragina F, Cristofaro MG. Management in oral and maxillofacial surgery during the COVID-19 pandemic: our experience. Br J Oral Maxillofac Surg. 2020;58:687–91.
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Prospective analysis |
33 Patients |
The main pathologies were traumas and non-differentiable oncological diseases, in particular 20 were fractures and 13 tumours |
1. Screening questionnaire.
2. The nasopharyngeal swab (RT-PCR) was performed at the time of admission and after 24 h and the patients remained in dedicated areas until the results were available.
3. Intraoperative protection: Healthcare staff used Personal protective equipment (PPE): N95 or FFP2 mask, eye protection, fluid-resistant gown, and surgical gloves.
4. Postoperative management: The patients remained hospitalised in individual rooms. They have undergone periodic control of the values of blood pressure, body temperature.
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All patients were negative. |
The authors recommended: Repetition of triage; 48 h of preoperative testing, before entering the ward, that includes two COVID-19 tests 24h apart (if both tests are negative, then surgery can proceed with enhanced airborne precautions); Accommodation in a single hospital room;
Speed of execution of the preoperative preparation
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Blackhall et al. (2020)1313 Blackhall KK, Downie IP, Ramchandani P, Kusanale A, Walsh S, Srinivasan B, et al. Provision of emergency maxillofacial service during the COVID-19 pandemic: a Collaborative Five Centre UK Study. Br J Oral Maxillofac Surg. 2020;58:698–703.
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Cross-sectional survey |
529 patients |
There were 255 trauma related cases, 221 infection and 48 cases of postoperative complications. |
We found a relatively good use of PPE, appropriate for the clinical activity undertaken across the region. All clinicians who undertook surgical intervention within the oral cavity utilized the appropriate PPE including FFP3 masks. There was a varying use of PPE for examination only and extra-oral surgery, however there was no evidence to suggest inadequate protection. |
The vast majority of the patients had an unknown COVID-19 status, however, were treated as if they were asymptomatic carriers of the infection. |
Having a robust remote patient management system, and pre-planned pathway for managing dental emergencies would alleviate undue pressure on the service which needs to be established in partnership with various stakeholders involved in providing dental services. |
Huntley et al. (2020)1414 Huntley RE, Ludwig DC, Dillon JK. Early effects of COVID-19 on oral and maxillofacial surgery residency training-results from a national survey. J Oral Maxillofac Surg. 2020;78:1257–67.
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Cross-sectional survey |
174 residency training |
All the respondents indicated that their programs had made modifications to the scheduling of elective cases, with 97.7% stating their program had stopped performing elective cases altogether. Urgent or emergent cases were also affected, with 83.6% of respondents indicating that changes had been made to the scheduling of these cases. |
Almost all residents (96.5%) reported modifications to their training program, and 14% had been reassigned to off-service clinical rotations (e.g., medicine, intensive care unit). The use of an N95 respirator mask plus standard PPE precautions during aerosol-generating procedures varied by procedure location, with 36.8% reporting limited access to these respirators. Widespread screening practices were in use, with 83.6% using laboratory-based viral testing. |
NI |
Sweeping alterations to oral and maxillofacial surgery clinical practice have occurred for those in Oral and maxillofacial surgery residency training programs during the COVID-19 pandemic. |
Maffia et al. (2020)1515 Maffia F, Fontanari M, Vellone V, Cascone P, Mercuri LG. Impact of COVID-19 on maxillofacial surgery practice: a worldwide survey. Int J Oral Maxillofac Surg. 2020;49:827–35.
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Cross-sectional survey |
166 oral and maxillofacial surgeons |
Traumatology was reported as the service that was most maintained, resulting in an OAI of 83.2%. Only 13.5% of the responding institutions had closed this subspecialty. Oral surgery, practiced in 90.4% of centers, decreased activity to 34.6%, with an overall reduction of 55.8% yielding and OAI of 38.3%. |
Over half (57.1%) of the maxillofacial surgery centres that reported not receiving any COVID-19 management guidelines, did not receive personal protective equipment (PPE) from their administration either. Furthermore, 7% of the centres despite receiving such guidelines, received no PPE. |
NI |
It seems appropriate to request that every healthcare institution receives well-researched and documented protocols for dealing with future inevitable global pandemics. |
van der Tas et al. (2020)1616 van der Tas J, Dodson T Buchbinder D, Fusetti S, Grant M, Leung YY, et al. The global impact of COVID-19 on craniomaxillofacial surgeons. Craniomaxillofac Trauma Reconstr. 2020;13:157–67.
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Cross-sectional survey |
511 oral and maxillofacial surgeons |
More than 80% of all surgeons in the different regions stopped performing elective surgery. |
The best protection offered to the surgeons is in Australia, where surgeons can work with N95/FFP2 masks (60.0%) or PAPR systems (40.0%), followed by North America reporting availability of N95/FFP2 masks (47.7%). |
NI |
The impact of COVID-19 among CMF surgeons is global and adversely affects both clinical practice and personal lives of craniomaxillofacial surgeons. |
Brar et al. (2021)1717 Brar B, Bayoumy M, Salama A, Henry A, Chigurupati R. A survey assessing the early effects of COVID-19 pandemic on oral and maxillofacial surgery training programs. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131:27–42.
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Cross-sectional survey |
95 residency program directors |
In the midst of the COVID-19 pandemic, all participating programs continued to provide limited patient services. These included emergency dental services (93.9%); emergent and urgent surgical procedures, such as repair of facial fractures or oncologic resection and reconstruction (93.9%); postoperative follow-up visits (75.8%); inpatient dental consultations (72.7%); and new outpatient consultations (36.4%). |
In the operating room setting, the level of PPE recommended for aerosol-generating procedures involving the aerodigestive tract for use by patients of unknown COVID-19 status comprised primarily an N95 respirator with full-face shield, disposable gown, and gloves (61.5%). |
NI |
OMFS training programs should give more consideration to providing residents with adequate stress reduction resources to maintain their well-being and training and to minimize exposure risk during an evolving global epidemic. |