Dhruv Sharma1,2, Michael J Ye1,2, Vincent J Campiti2, Kolin E Rubel1,2, Thomas S Higgins3,4, Arthur W Wu5, Taha Z Shipchandler1, Michael W Sim1, Sarah J Burgin1, Elisa A Illing1, Jae Hong Park6, Jonathan Y Ting1. 1. Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA. 2. School of Medicine, Indiana University, Indianapolis, Indiana, USA. 3. Department of Otolaryngology-Head and Neck Surgery, University of Louisville, Louisville, Kentucky, USA. 4. Rhinology, Sinus, and Skull Base, Kentuckiana Ear, Nose, and Throat, Louisville, Kentucky, USA. 5. Department of Otolaryngology-Head and Neck Surgery, Cedars Sinai, Los Angeles, California, USA. 6. School of Health Sciences, Purdue University, West Lafayette, Indiana, USA.
Abstract
OBJECTIVE: After significant restrictions initially due to the COVID-19 pandemic, otolaryngologists have begun resuming normal clinical practice. However, the risk of SARS-CoV-2 transmission to health care workers through aerosolization and airborne transmission during rhinologic surgery remains incompletely characterized. The objective of this study was to quantify the number concentrations of aerosols generated during rhinologic surgery with and without interventions involving 3 passive suction devices. STUDY DESIGN: Cadaver simulation. SETTING: Dedicated surgical laboratory. SUBJECTS AND METHODS: In a simulation of rhinologic procedures with and without different passive suction interventions, the concentrations of generated aerosols in the particle size range of 0.30 to 10.0 µm were quantified with an optical particle sizer. RESULTS: Functional endoscopic sinus surgery with and without microdebrider, high-speed powered drilling, use of an ultrasonic aspirator, and electrocautery all produced statistically significant increases in concentrations of aerosols of various sizes (P < .05). Powered drilling, ultrasonic aspirator, and electrocautery generated the highest concentration of aerosols, predominantly submicroparticles <1 µm. All interventions with a suction device were effective in reducing aerosols, though the surgical smoke evacuation system was the most effective passive suction method in 2 of the 5 surgical conditions with statistical significance (P < .05). CONCLUSION: Significant aerosol concentrations were produced in the range of 0.30 to 10.0 µm during all rhinologic procedures in this cadaver simulation. Rhinologic surgery with a passive suction device results in significant mitigation of generated aerosols.
OBJECTIVE: After significant restrictions initially due to the COVID-19 pandemic, otolaryngologists have begun resuming normal clinical practice. However, the risk of SARS-CoV-2 transmission to health care workers through aerosolization and airborne transmission during rhinologic surgery remains incompletely characterized. The objective of this study was to quantify the number concentrations of aerosols generated during rhinologic surgery with and without interventions involving 3 passive suction devices. STUDY DESIGN: Cadaver simulation. SETTING: Dedicated surgical laboratory. SUBJECTS AND METHODS: In a simulation of rhinologic procedures with and without different passive suction interventions, the concentrations of generated aerosols in the particle size range of 0.30 to 10.0 µm were quantified with an optical particle sizer. RESULTS: Functional endoscopic sinus surgery with and without microdebrider, high-speed powered drilling, use of an ultrasonic aspirator, and electrocautery all produced statistically significant increases in concentrations of aerosols of various sizes (P < .05). Powered drilling, ultrasonic aspirator, and electrocautery generated the highest concentration of aerosols, predominantly submicroparticles <1 µm. All interventions with a suction device were effective in reducing aerosols, though the surgical smoke evacuation system was the most effective passive suction method in 2 of the 5 surgical conditions with statistical significance (P < .05). CONCLUSION: Significant aerosol concentrations were produced in the range of 0.30 to 10.0 µm during all rhinologic procedures in this cadaver simulation. Rhinologic surgery with a passive suction device results in significant mitigation of generated aerosols.
Entities:
Keywords:
COVID-19; SARS-CoV-2; aerosol particles; aerosol-generating procedure; airborne; endonasal drilling; sinus surgery; skull base surgery
Authors: Rushi Patel; Christina H Fang; Jordon G Grube; Jean Anderson Eloy; Wayne D Hsueh Journal: Oper Tech Otolayngol Head Neck Surg Date: 2022-04-28
Authors: Mari Lahelma; Lotta Oksanen; Noora Rantanen; Saku Sinkkonen; Antti Aarnisalo; Ahmed Geneid; Enni Sanmark Journal: Otol Neurotol Date: 2022-07-28 Impact factor: 2.619
Authors: Dhruv Sharma; Vincent J Campiti; Michael J Ye; Kolin E Rubel; Thomas S Higgins; Arthur W Wu; Taha Z Shipchandler; Sarah J Burgin; Michael W Sim; Elisa A Illing; Jae Hong Park; Jonathan Y Ting Journal: Laryngoscope Investig Otolaryngol Date: 2021-01-14
Authors: Dhruv Sharma; Vincent J Campiti; Michael J Ye; Mohamad Saltagi; Aaron E Carroll; Jonathan Y Ting; Elisa A Illing; Jae Hong Park; Rick F Nelson; Sarah J Burgin Journal: Laryngoscope Investig Otolaryngol Date: 2020-12-16