Transmission risk of COVID-19 infection with office-based flexible laryngoscopy

Am J Otolaryngol. 2023 May-Jun;44(3):103816. doi: 10.1016/j.amjoto.2023.103816. Epub 2023 Feb 25.


Since the beginning of the Coronavirus pandemic, recommendations to ensure safety in clinical practice have fluctuated. Within the Otolaryngology community, a variety of protocols have emerged to assure safety for both patients and healthcare workers while maintaining standard of care practices, especially surrounding aerosolizing in-office procedures.

Objectives: This study aims to describe our Otolaryngology Department's Personal Protective Equipment protocol for both patients and providers during office laryngoscopy and to identify the risk of contracting COVID-19 after implementation of the protocol.

Methods: 18,953 office visits divided between 2019 and 2020 where laryngoscopy was performed were examined and compared to the rate of COVID-19 contraction for both office staff and patients within a 14 day period after the encounter. Of these visits, two cases were examined and discussed; where a patient tested positive for COVID-19 ten days after office laryngoscopy, and one where a patient tested positive for COVID-19 ten days prior to office laryngoscopy.

Results: In the year 2020, 8337 office laryngoscopies were performed, 100 patients tested positive within the year 2020, with only these 2 cases of COVID-19 infections occurring within 14 days prior to or after their office visit.

Conclusion: These data suggest that using CDC-compliant protocol for aerosolizing procedures, such as office laryngoscopy, can provide a safe and effective method for mitigating infectious risk while providing timely quality care for the otolaryngology patient.

Level of evidence: 3 LAY SUMMARY: During the COVID-19 Pandemic, ENTs have had to balance providing care while minimizing the risk of COVID-19 transmission with routine office procedures such as flexible laryngoscopy. In this large chart review, we show that the risk of transmission is low with CDC-compliant protective equipment and cleaning protocols.

Keywords: Comprehensive otolaryngology; Covid-19; Laryngoscopy.

MeSH terms

  • COVID-19*
  • Humans
  • Laryngoscopy
  • Otolaryngology*
  • Pandemics / prevention & control
  • SARS-CoV-2