Aerosol Dispersion During Mastoidectomy and Custom Mitigation Strategies for Otologic Surgery in the COVID-19 Era
OBJECTIVE: To investigate small-particle aerosolization from mastoidectomy relevant to potential viral transmission and to test source-control mitigation strategies.
STUDY DESIGN: Cadaveric simulation.
SETTING: Surgical simulation laboratory.
METHODS: An optical particle size spectrometer was used to quantify 1- to 10-µm aerosols 30 cm from mastoid cortex drilling. Two barrier drapes were evaluated: OtoTent1, a drape sheet affixed to the microscope; OtoTent2, a custom-structured drape that enclosed the surgical field with specialized ports.
RESULTS: Mastoid drilling without a barrier drape, with or without an aerosol-scavenging second suction, generated large amounts of 1- to 10-µm particulate. Drilling under OtoTent1 generated a high density of particles when compared with baseline environmental levels (P < .001, U = 107). By contrast, when drilling was conducted under OtoTent2, mean particle density remained at baseline. Adding a second suction inside OtoTent1 or OtoTent2 kept particle density at baseline levels. Significant aerosols were released upon removal of OtoTent1 or OtoTent2 despite a 60-second pause before drape removal after drilling (P < .001, U = 0, n = 10, 12; P < .001, U = 2, n = 12, 12, respectively). However, particle density did not increase above baseline when a second suction and a pause before removal were both employed.
CONCLUSIONS: Mastoidectomy without a barrier, even when a second suction was added, generated substantial 1- to 10-µm aerosols. During drilling, large amounts of aerosols above baseline levels were detected with OtoTent1 but not OtoTent2. For both drapes, a second suction was an effective mitigation strategy during drilling. Last, the combination of a second suction and a pause before removal prevented aerosol escape during the removal of either drape.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:164 |
|---|---|
| Enthalten in: |
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery - 164(2021), 1 vom: 01. Jan., Seite 67-73 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chari, Divya A [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 12.01.2021 Date Revised 29.01.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/0194599820941835 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM312370040 |
|---|
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| 024 | 7 | |a 10.1177/0194599820941835 |2 doi | |
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| 035 | |a (NLM)32660367 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Chari, Divya A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Aerosol Dispersion During Mastoidectomy and Custom Mitigation Strategies for Otologic Surgery in the COVID-19 Era |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 12.01.2021 | ||
| 500 | |a Date Revised 29.01.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To investigate small-particle aerosolization from mastoidectomy relevant to potential viral transmission and to test source-control mitigation strategies | ||
| 520 | |a STUDY DESIGN: Cadaveric simulation | ||
| 520 | |a SETTING: Surgical simulation laboratory | ||
| 520 | |a METHODS: An optical particle size spectrometer was used to quantify 1- to 10-µm aerosols 30 cm from mastoid cortex drilling. Two barrier drapes were evaluated: OtoTent1, a drape sheet affixed to the microscope; OtoTent2, a custom-structured drape that enclosed the surgical field with specialized ports | ||
| 520 | |a RESULTS: Mastoid drilling without a barrier drape, with or without an aerosol-scavenging second suction, generated large amounts of 1- to 10-µm particulate. Drilling under OtoTent1 generated a high density of particles when compared with baseline environmental levels (P < .001, U = 107). By contrast, when drilling was conducted under OtoTent2, mean particle density remained at baseline. Adding a second suction inside OtoTent1 or OtoTent2 kept particle density at baseline levels. Significant aerosols were released upon removal of OtoTent1 or OtoTent2 despite a 60-second pause before drape removal after drilling (P < .001, U = 0, n = 10, 12; P < .001, U = 2, n = 12, 12, respectively). However, particle density did not increase above baseline when a second suction and a pause before removal were both employed | ||
| 520 | |a CONCLUSIONS: Mastoidectomy without a barrier, even when a second suction was added, generated substantial 1- to 10-µm aerosols. During drilling, large amounts of aerosols above baseline levels were detected with OtoTent1 but not OtoTent2. For both drapes, a second suction was an effective mitigation strategy during drilling. Last, the combination of a second suction and a pause before removal prevented aerosol escape during the removal of either drape | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a OtoTent | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a aerosol | |
| 650 | 4 | |a aerosol generating procedure | |
| 650 | 4 | |a aerosolization | |
| 650 | 4 | |a airborne | |
| 650 | 4 | |a barrier drape | |
| 650 | 4 | |a health care providers | |
| 650 | 4 | |a mastoidectomy | |
| 650 | 4 | |a neurotology | |
| 650 | 4 | |a otology | |
| 650 | 4 | |a personal protective equipment | |
| 650 | 4 | |a safety | |
| 650 | 4 | |a severe acute respiratory syndrome coronavirus-2 | |
| 650 | 4 | |a virus transmission | |
| 650 | 7 | |a Aerosols |2 NLM | |
| 700 | 1 | |a Workman, Alan D |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Jenny X |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, David H |e verfasserin |4 aut | |
| 700 | 1 | |a Abdul-Aziz, Dunia |e verfasserin |4 aut | |
| 700 | 1 | |a Kozin, Elliott D |e verfasserin |4 aut | |
| 700 | 1 | |a Remenschneider, Aaron K |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Daniel J |e verfasserin |4 aut | |
| 700 | 1 | |a Welling, D Bradley |e verfasserin |4 aut | |
| 700 | 1 | |a Bleier, Benjamin S |e verfasserin |4 aut | |
| 700 | 1 | |a Quesnel, Alicia M |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |d 1982 |g 164(2021), 1 vom: 01. Jan., Seite 67-73 |w (DE-627)NLM012595721 |x 1097-6817 |7 nnns |
| 773 | 1 | 8 | |g volume:164 |g year:2021 |g number:1 |g day:01 |g month:01 |g pages:67-73 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/0194599820941835 |3 Volltext |
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