The influence of the COVID-19 pandemic on the work of the Department of Ear, Nose, Throat and Head and Neck Surgery in University Hospital Centre Zagreb

Aim: The aim of this study was to show changes in the work of the Ear, Nose, Throat and Head and Neck Surgery Department, UHC Zagreb, during the COVID-19 pandemic. Methods: We retrospectively extracted and compared the data on the procedures and diagnoses of the Department during the period from January 1st to April 30th in 2019, 2020 and 2021. Results:The total number of cases was lower by 34.2% in 2020, and by 13.19% in 2021, compared to 2019 (p<0.001). The Head and Neck Surgery Division recorded a decrease of 31.9%, Division of Children's Otolaryngology 41.9%, Otology Division 66.7%, and Rhinosinusology Division 82.5%. Maxillofacial Surgery Division and Head and Neck Tumours Divisions recorded an increase of 71.1% and 31.1%, respectively. The review of diagnoses revealed a decrease in the number of thyroid disorders (-57.1%), nasal septum deviations (-85.1%), middle ear and mastoid process diseases (-75.35%), and diseases of the tonsils (-52.6%). There was an increase in the number of head and neck tumours (165.4%), facial bones fractures (95%), and cleft lip and palate (19 in 2021, none in 2019 and 2020). There were 35% more newly diagnosed laryngeal cancers in 2021 than in 2019. The number of T1 laryngeal cancers was lower by 22.2%, while the number of T2 increased by 133%. Conclusions: This study showed the decrease in the overall number of procedures since the start of the pandemic, but also an incremental increase in the complexity and the number of oncological surgical procedures. Our results demonstrated that managing the increased number of complex head and neck surgery patients is possible even in the extraordinary conditions in the well organised and equipped institution. This points to the importance of developing centres of excellence, which can provide the high standards of treatment even when the health care system is under increased pressure. © 2021 Hrvatski Lijecnicki Zbor. All rights reserved.