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The coronavirus disease 2019 (COVID-19) pandemic is a rapidly evolving scenario that is changing the medical landscape. Real-time reverse transcription–polymerase chain reaction of nasopharyngeal swab (NPS) specimens is the preferred method of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing.1 However, blind NPS testing poses risk to patients with sinus pathology. Sinus and skull-base surgery frequently removes bony partitions between the nasal cavity and skull base, resulting in the exposure of critical neurovascular structures. After surgery, patients are theoretically at higher risk of cerebrospinal fluid leak and neurovascular damage during NPS insertion.2 In fact, recent reports illustrate the risk of cerebrospinal fluid leak caused by NPS insertion during SARS-CoV-2 testing.3
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Accepted for Publication: December 17, 2020.
Published Online: March 4, 2021. doi:10.1001/jamaoto.2020.5663
Corresponding Author: Philip G. Chen, MD, Department of Otolaryngology–Head and Neck Surgery, University of Texas Health San Antonio, 7703 Floyd Curl Dr, MC 7777, San Antonio, TX 78229 (email@example.com).
Author Contributions: Mr Fish and Dr Issa had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: All authors.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Fish, Issa, Jang.
Critical revision of the manuscript for important intellectual content: All authors.
Administrative, technical, or material support: All authors.
Supervision: All authors.
Other—supplied references and helped develop figures: Levine.
Conflict of Interest Disclosures: Dr Levine reported receiving grants from the National Institute on Deafness and Other Communication outside the submitted work. Dr Chen reported receiving consulting fees from Medtronic, Stryker, and Integra outside the submitted work. No other disclosures were reported.
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