Methods
The MD Anderson Head and Neck Surgery Consortium incorporates faculty
and advanced practice providers from the five subsections of the
Department of Head and Neck Surgery at the University of Texas MD
Anderson Cancer Center: Head and Neck Surgical Oncology, Head and Neck
Endocrine Surgery, Oral Oncology and Maxillofacial Prosthodontics,
Ophthalmology, and Speech Pathology and Audiology. In a collaborative
effort, the following guidelines were prepared to provide clinicians
subsite-specific guidance for triaging surgical case acuity. Expertise
was sought from our Radiation Oncology and Medical Oncology colleagues
for non-surgical treatment options when surgery could be reasonably
deferred, and for patients requiring multi-modality therapy. These
guidelines are intended to serve as direction in a time of crisis such
as the COVID-19 pandemic and not as a strategy for permanent change in
patterns of practice.
Our weekly Multidisciplinary Planning Conference is currently conducted
over a web conferencing platform in accordance with institutional and
national social distancing recommendations. When a case is selected for
surgery, a case posting request is placed and sent to the Division of
Surgery Surgical Posting Committee for daily institutional review. This
committee is comprised of surgical department chairs and quality
officers, the Operating Room Committee leadership, and
anesthesiologists. In Head and Neck Surgery, the guidelines described
below are currently being used to assess treatment decisions and to make
recommendations to the Division of Surgery Surgical Posting Committee.
Approved cases are forwarded to the surgical scheduling team. An
institutional bioethicist is available as needed.