The Impact of the COVID-19 Pandemic on the Management of Oral and Maxillofacial Patients Under General Anaesthesia at Charlotte Maxeke Johannesburg Academic Hospital

Abstract

AIM OF THE STUDY The purpose of the study was to determine the impact of the COVID-19 pandemic on the management of oral and maxillofacial patients at the Charlotte Maxeke Johannesburg Academic Hospital. OBJECTIVES 1. Determine the type and distribution of MFOS procedures performed under general anesthesia in CMJAH one year before the COVID-19 pandemic. 2. Determine the type and distribution of the MFOS procedures performed at CMJAH during the COVID-19 pandemic. 3. Compare MFOS procedures performed before and during the pandemic. 4. Determine the most common emergency with MFOS during the COVID-19 pandemic. STUDY DESIGN This was a retrospective, quantitative study conducted with records of patients who had oral and maxillofacial surgical procedures under general anaesthesia at Charlotte Maxeke Johannesburg Academic Hospital between 23 March 2019 and 23 March 2021. MAJOR RESULTS The sample consisted of 853 patients who underwent oral and maxillofacial surgical procedures under general anaesthesia at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 23 March 2019 and 23 March 2021. The most common MFOS procedure performed one year before the COVID-19 pandemic was open reduction and internal fixation (ORIF) (49.9%) and the least common was examination under general anaesthesia (0.2%). III During the COVID-19 pandemic, the most common MFOS procedure performed was also open reduction and internal fixation (58.2%) and the least common procedure was marsupialization (0.5%). More male patients (91.7%) had ORIF performed on them than females (8.3%) before and 88.8% males and 11.2% females during the COVID-19 pandemic. The frequency of MFOS procedures performed before the pandemic was 62%, while 322 (38%) of the procedures were performed after the pandemic. Facial fractures as a result of trauma (68.6%) were the most common emergency for MFOS treated during the COVID-19 pandemic. CONCLUSION This study demonstrated that there were more MFOS procedures performed under general anesthesia in CMJAH before the COVID-19 pandemic (62%) than the procedures performed during the pandemic (38%). Additionally, it showed that open reduction was the most common type of MFOS procedure performed both a year before and one year after COVID- 19 was declared a pandemic. There was an increase in trauma as an indication for surgery during the pandemic, with 68.6% of traumatology cases treated under general anaesthesia, making trauma the most common MFOS emergency during the COVID-19 pandemic. The study also showed that more men received oral and maxillofacial surgery both before (77.4%) and during (70%) the COVID-19 pandemic.