Open AccessDroplet Exposure Risk to Providers From In‐Office Flexible Laryngoscopy: A COVID‐19 Simulation
Author(s) -
Ye Michael J.,
Sharma Dhruv,
Rubel Kolin E.,
Lebo Nicole L.,
Burgin Sarah J.,
Illing Elisa A.,
Ting Jonathan Y.,
Moore Michael G.,
Yesensky Jessica A.,
Mantravadi Avinash V.,
Sim Michael W.
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 - 10.1177/0194599820952800
Subject(s) - laryngoscopy , medicine , rhinorrhea , anesthesia , covid-19 , nasal congestion , nasal passages , nose , surgery , intubation , disease , infectious disease (medical specialty)
To provide data on risk of respiratory droplets from common otolaryngologic procedures during the COVID‐19 pandemic, a novel simulation of droplet exposure from flexible laryngoscopy was performed. After completion of a nasal symptom questionnaire, topical fluorescein spray was administered into the nasal and oropharynx of 10 healthy volunteers, who then underwent flexible laryngoscopy under 2 conditions: routine without provoked response and with prompted sneeze/cough. After each, droplets on the proceduralist and participant were counted under ultraviolet A light. Droplets were observed on 1 of 10 volunteers after routine laryngoscopy and 4 of 10 during laryngoscopy with sneeze/cough. A nasal symptom score based on congestion and rhinorrhea was significantly elevated among droplet producers after sneeze/cough ( P =. 0164). No droplets were observed on the provider. Overall, with adequate personal protective equipment, flexible laryngoscopy poses minimal droplet risk to providers. Nasal symptoms can identify patients more likely to produce droplets after sneeze/cough.