The current pandemic of SARS-CoV-2 (COVID-19) virus has led to heightened awareness of clinical spread of virus, particularly during operative procedures involving aerosol generation. Data is limited on extent of spread during various anterior and lateral skull base surgical procedures, particularly those procedures using powered instrumentation (with the resultant increase in aerosolization of viral particles). We will review contagion spread with help of established clinical spread models and discuss applicability to the current pandemic. Evidence-based practices, highlighted by case-based examples, will be emphasized in both anterior and lateral skull base surgery. Principles for planning for and managing future such epidemics and/or pandemics will be discussed. This panel is highly relevant to the practicing otolaryngologist and will provide the attendee with a thorough update clinical practice patterns, potential spread of contagion and strategies of spread mitigation. Urgent cranial base operations often continued to be performed during the pandemic, and review of these cases can help to plan for less urgent operations in ongoing and future epidemics.