Reducing aerosolized particles and droplet spread in endoscopic sinus Surgery during COVID-19
Reducing aerosolized particles and droplet spread in endoscopic sinus Surgery during COVID-19
OBJECTIVES: The presence of high SARS-Cov-2 viral loads in the upper airway, including the potential for aerosolized transmission of viral particles, has generated significant concern amongst otolaryngologists worldwide, particularly those performing endoscopic sinus surgery (ESS). We evaluated a simple negative-pressure mask technique to reduce viral exposure.
METHODS: Two models simulating respiratory droplets >5-10 μm and fine respiratory nuclei <5 μm using fluorescein dye and wood smoke, respectively, were utilized in a fixed cadaveric study in a controlled environment. Using ultraviolet light, fluorescein droplet spread was assessed during simulated ESS with powered microdebrider and powered drilling. Wood smoke ejection was used to evaluate fine particulate escape from a negative-pressure mask using digital subtraction image processing.
RESULTS: The use of a negative-pressure mask technique resulted in 98% reduction in the fine particulate aerosol simulation and eliminated larger respiratory droplet spread during simulated ESS, including during external drill activation.
CONCLUSIONS: As global ear, nose & throat (ENT) services resume routine elective operating, we demonstrate the potential use of a simple negative-pressure mask technique to reduce the risk of viral exposure for the operator and theatre staff during ESS.
LEVEL OF EVIDENCE: 5 Laryngoscope, 131:956-960, 2021.
Aerosols/adverse effects, Air Pressure, COVID-19/diagnosis, Cadaver, Disease Transmission, Infectious/prevention & control, Endoscopy/methods, Equipment Design/instrumentation, Humans, Infection Control/methods, Infectious Disease Transmission, Patient-to-Professional/prevention & control, Masks/virology, Occupational Exposure/prevention & control, Paranasal Sinus Diseases/surgery, SARS-CoV-2/genetics, Simulation Training/methods, Virion
956-960
Jones, Huw A S
64a99998-3d12-4a86-9533-1d14019eddfd
Salib, Rami J
d6fde1c1-5b5e-43f7-ae1c-42cce6a0c9fc
Harries, Philip G
df33be64-b580-4fdf-ac4d-4c842b55d753
May 2021
Jones, Huw A S
64a99998-3d12-4a86-9533-1d14019eddfd
Salib, Rami J
d6fde1c1-5b5e-43f7-ae1c-42cce6a0c9fc
Harries, Philip G
df33be64-b580-4fdf-ac4d-4c842b55d753
Jones, Huw A S, Salib, Rami J and Harries, Philip G
(2021)
Reducing aerosolized particles and droplet spread in endoscopic sinus Surgery during COVID-19.
The Laryngoscope, 131 (5), .
(doi:10.1002/lary.29065).
Abstract
OBJECTIVES: The presence of high SARS-Cov-2 viral loads in the upper airway, including the potential for aerosolized transmission of viral particles, has generated significant concern amongst otolaryngologists worldwide, particularly those performing endoscopic sinus surgery (ESS). We evaluated a simple negative-pressure mask technique to reduce viral exposure.
METHODS: Two models simulating respiratory droplets >5-10 μm and fine respiratory nuclei <5 μm using fluorescein dye and wood smoke, respectively, were utilized in a fixed cadaveric study in a controlled environment. Using ultraviolet light, fluorescein droplet spread was assessed during simulated ESS with powered microdebrider and powered drilling. Wood smoke ejection was used to evaluate fine particulate escape from a negative-pressure mask using digital subtraction image processing.
RESULTS: The use of a negative-pressure mask technique resulted in 98% reduction in the fine particulate aerosol simulation and eliminated larger respiratory droplet spread during simulated ESS, including during external drill activation.
CONCLUSIONS: As global ear, nose & throat (ENT) services resume routine elective operating, we demonstrate the potential use of a simple negative-pressure mask technique to reduce the risk of viral exposure for the operator and theatre staff during ESS.
LEVEL OF EVIDENCE: 5 Laryngoscope, 131:956-960, 2021.
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Published date: May 2021
Additional Information:
© 2021 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).
Keywords:
Aerosols/adverse effects, Air Pressure, COVID-19/diagnosis, Cadaver, Disease Transmission, Infectious/prevention & control, Endoscopy/methods, Equipment Design/instrumentation, Humans, Infection Control/methods, Infectious Disease Transmission, Patient-to-Professional/prevention & control, Masks/virology, Occupational Exposure/prevention & control, Paranasal Sinus Diseases/surgery, SARS-CoV-2/genetics, Simulation Training/methods, Virion
Identifiers
Local EPrints ID: 501380
URI: http://eprints.soton.ac.uk/id/eprint/501380
ISSN: 0023-852X
PURE UUID: f23a0d95-a0a4-4bcd-8142-fdf699ae2f77
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Date deposited: 30 May 2025 16:38
Last modified: 31 May 2025 01:39
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Author:
Huw A S Jones
Author:
Philip G Harries
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