Trends in otolaryngology-head and neck surgery procedural volumes during the COVID-19 pandemic

Background: The COVID-19 pandemic significantly impacted procedural volumes across all surgical specialties. This study aims to assess trends two years after the start of the pandemic and analyze the current surgical volume in Otolaryngology-Head and Neck Surgery.Methods: The COVID-19 TriNetX database, consisting of 67 health care organizations (HCOs) was utilized to collect de-identified data patients that underwent otolaryngologic surgical procedures from February 1, 2018 to January 31, 2022. The pre-pandemic (2018 to 2019) and post-pandemic (2020 to 2021) periods were analyzed and compared for surgical volumes by season, surgical subspecialty, and procedure type. Student's t-test was utilized to test for statistical significance of trends between seasonal averages pre- and post-pandemic.  Results: A total of 2,005,796 otolaryngology surgical procedures from 45 HCOs were included. When comparing the average monthly post-pandemic (2020 and 2021) volumes to their pre-pandemic (2018 and 2019) seasonal counterparts, there were statistically significant decreases in the averages of all seasons. Post-pandemic seasonal volumes assessed by individual years depicted a significant decline in the total otolaryngology surgical volumes in all seasons, with the steepest reduction from Winter 2019 to Spring 2020.Conclusions: Specialties that experienced significant reductions in volume without sufficient evidence of rebounding trends include paediatric otolaryngology and otology, while general/rhinology/endoscopy, laryngology, head and neck surgery, and facial plastics and reconstructive surgery are trending towards pre-pandemic baselines.