Open AccessMitigation of Aerosols Generated During Rhinologic Surgery: A Pandemic‐Era Cadaveric Simulation
Author(s) -
Sharma Dhruv,
Ye Michael J.,
Campiti Vincent J.,
Rubel Kolin E.,
Higgins Thomas S.,
Wu Arthur W.,
Shipchandler Taha Z.,
Sim Michael W.,
Burgin Sarah J.,
Illing Elisa A.,
Park Jae Hong,
Ting Jonathan Y.
Publication year - 2021
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599820951169
Subject(s) - aspirator , medicine , suction , aerosolization , aerosol , surgery , anesthesia , inhalation , meteorology , physics
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.