Letter: COVID Conundrum: Postoperative COVID-19 Infections Following Endonasal Transsphenoidal Pituitary Surgery

Early in the COVID-19 global pandemic, the neurosurgical and otolaryngology communities recognized that endonasal, transsphenoidal surgeries were particularly high risk for intraoperative exposure to aerosolized viral particles from the traumatized nasal mucosa 1 As a result, recommendations were put into place to protect the health care teams, with testing for COVID-19 infection strongly recommended 48 h prior to transsphenoidal surgery and team members recommended to wear full PPE even in COVID-19 negative cases as an added precaution against false negative tests 2 However, less is known about if and how transsphenoidal surgery affects the patients’ susceptibility to contracting COVID-19 In this report, we describe 3 patients with negative preoperative COVID-19 tests, who developed a postoperative COVID-19 infection shortly after their transsphenoidal surgery, and discuss the potential implications of these observations Given the lack of protected health and/or identifying information in the clinical vignettes, patient consent was not sought prior to this correspondence