The COVID 19 pandemic is the defining global health crisis of our time and one of the greatest challenges faced by mankind in recent times. Since its emergence in the city of Wuhan in China in 2019, the virus has spread to every corner of the world and has been declared a pandemic by the World Health Organization.

The frontline healthcare workers are at a greater risk compared to the rest of the population. Among the healthcare workers too, the doctors at greatest risk are the Otolaryngologists. Airborne transmission of the virus from the upperairway make the Otolaryngologists at risk of viral infection, and therefore it is best to postpone elective surgeries of nose and throat. It is still unclear whether the respiratory lining of the middle ear and mastoid cell system are involved by COVID 19 or not, but most likely they are. As the nose and the nasopharynx are involved, it seems only obvious that the middle ear and the mastoid air system are also contaminated by the virus, as the epithelium of the middle ear and the mastoid are similar to mucosa of the upper respiratory tract.

Mastoidectomy and other procedures that use a high-speed drill are all aerosol generating procedures. If the virus is present in these aerosols, then the risk of transmission of SARS-CoV2 to the OT staff may be significant. In such a scenario, the use of endoscope may be a safer alternative compared to other aerosol generating procedures, without compromising disease clearance. TEES also allows for the use of eye goggles and face shields that are difficult to use with a microscope.

Endoscopic ear surgeriesare slowly gaining popularity due to its excellent optics, visualization and minimally invasive surgical technique. Endoscopes provide better visualization of the middle ear, ossicles, Eustachian tube orifice and other hidden areas of the middle ear. A short surgical time and cosmesis are the other benefits of endoscopic ear surgery. It is not long before the endoscopes will replace the microscopes as a tool for ear surgery.