Airborne Aerosol Generation During Endonasal Procedures in the Era of COVID-19: Risks and Recommendations.

Airborne Aerosol Generation During Endonasal Procedures in the Era of COVID-19: Risks and Recommendations.

Publication date: May 26, 2020

In the era of SARS-CoV-2, the risk of infectious airborne aerosol generation during otolaryngologic procedures has been an area of increasing concern. The objective of this investigation was to quantify airborne aerosol production under clinical and surgical conditions and examine efficacy of mask mitigation strategies.

Prospective quantification of airborne aerosol generation during surgical and clinical simulation.

Cadaver laboratory and clinical examination room.

Airborne aerosol quantification with an optical particle sizer was performed in real time during cadaveric simulated endoscopic surgical conditions, including hand instrumentation, microdebrider use, high-speed drilling, and cautery. Aerosol sampling was additionally performed in simulated clinical and diagnostic settings. All clinical and surgical procedures were evaluated for propensity for significant airborne aerosol generation.

Hand instrumentation and microdebridement did not produce detectable airborne aerosols in the range of 1 to 10 ?m. Suction drilling at 12,000 rpm, high-speed drilling (4-mm diamond or cutting burs) at 70,000 rpm, and transnasal cautery generated significant airborne aerosols (P

Transnasal drill and cautery use is associated with significant airborne particulate matter production in the range of 1 to 10 ?m under surgical conditions. During simulated clinical activity, airborne aerosol generation was seen during nasal endoscopy, speech, and sneezing. Intact or VENT-modified N95 respirators mitigated airborne aerosol transmission, while standard surgical masks did not.

Concepts Keywords
Aerosol Particulates
Aerosols Solids
Airborne Colloids
Airborne Particulate Matter Colloidal chemistry
Cautery Physical chemistry
Clinical Examination Aerosols
Diamond Cutting Chemistry
Endoscopic Natural sciences
Endoscopy Physical sciences
Nasal Surgery
Otolaryngologic Cautery
Respirator SARS
Rpm Human nose
SARS Surgical mask
Simulation Endoscopy
Sneezing Simulation
Surgical Mask
Surgical Masks

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