A cluster of viral pneumonia cases associated with a novel Coronavirus (2019-nCoV) was first identified in Wuhan, Hubei Province, China, in December 2019 and has rapidly spread around the world, causing a global health crisis.1 The disease was subsequently named Coronavirus Disease—2019 (COVID-19) by the World Health Organization (WHO) and has been designated SARS-CoV-2.2 Significant concern has arisen within the global community to the potential risks of infectious transmission of SARS-CoV-2 to the surgical team during endoscopic sinonasal and skull base surgery. As information has rapidly evolved, it has become clear that the presence of elevated viral load in the upper airway mucosa impacts not only skull base cases but also virtually all diagnostic and therapeutic intranasal procedures routinely performed by Otolaryngologists. Despite this, there has been little to no evidence-based data to guide best practices thus far. Although we hope this will be one of the first of many studies coming from our scientific community, we have attempted to evaluate the literature regarding aerosol generating procedures and evaluate a protocol to protect our patients and our colleagues in the face of this new threat.


1. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270–273.
2. Gorbalenya AE, Baker SC, Baric RS, et al. Severe acute respiratory syndrome-related coronavirus: the species and its viruses—a statement of the Coronavirus Study Group. bioRxiv. 2020. doi: 10.1038/s41564-020-0695-z. 3. Bai Y, Yao L, Wei T, et al. Presumed asymptomat