Head and neck cancers in the emergency department during COVID-19 Pandemic

ABSTRACT

Introduction/Aims: The impact of COVID-19 pandemic on human life is morbid & unparalleled. During this period, patients with oral lesions were experiencing increased difficulty accessing primary care and being followed up in person in secondary care. This led to a surge of patients with painful orofacial lesions presenting to the emergency department. We attempt to analyse these hospital attendances during the pandemic and its troubling impact on the welfare of these patients. Material(s) and Method(s) Data was collected of all patients referred to the Oral and Maxillofacial team from our emergency department between March 2020 and October 2021. Those that were referred with oral ulceration and non-odontogenic neck swellings were identified and their diagnoses and treatment recorded. Results/Statistics Out of 2774 patients referred to the maxillofacial department 34 presented with oral ulcerations or neck swellings. Nine patients (n=9) were diagnosed with oral/oropharyngeal cancer. All cancers were graded stage 4 and only one patient was deemed suitable for surgery. Three patients had recurrent or progressive disease and two patients sadly deceased. Conclusions/Clinical Relevance Our analyses shows that patients were presenting at later stages of the disease. Significant reduction in 2 week wait referrals from primary care during the pandemic was noted in many studies. It is therefore inferred correctly that access to care services was difficult during the COVID-19 pandemic prompting increased number of presentations in the emergency department. Safe triaging and support of these vulnerable patients is necessary in this unpredictable climate. Copyright © 2022