Steroid use in ENT- -COVID-19 challenges

We use steroids quite a bit in ENT- both local and systemic. But COVID-19 poses a unique challenge because most systemic steroids suppress the immune system. But there are instances when their use is clearly indicated-so a consensus statement was issued.

Steroid use is definitely recommended for:

1. Bell’s palsy or herpetic facial paralysis (Bell’ s palsy is a name given to isolated facial paralysis-it is sometimes caused by the herpesvirus).
2. Sudden hearing loss
3. Flare-ups of Meniere’s disease (Meniere’s disease is a complex condition—episodic hearing loss and dizziness. Unfortunately, it is progressive, with flare-ups)
4. Anosmia (loss of smell) from COVID-19
5. Other disorders of the nose-nasal polyps, allergies. Sometimes systemic steroids are needed to shrink nasal polyps, but polyps often can be controlled with topical nasal steroid sprays –and fortunately they don’t have systemic effects.

All of these conditions are treated with high-dose systemic steroids. They are usually in a tapering dose (high àlow) over about a month. If you need systemic steroids consider yourself high-risk…. definitely practice the CDC guidelines extensively—mask, social distancing, handwashing etc…