Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Indiana University, Indianapolis, Indiana, USA.
Otolaryngol Head Neck Surg. 2021 Jan;164(1):93-96. doi: 10.1177/0194599820952800. Epub 2020 Aug 18.
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 ( = .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.
为了提供有关 COVID-19 大流行期间常见耳鼻喉科手术过程中呼吸飞沫风险的数据，我们对软性喉镜检查过程中的飞沫暴露进行了新的模拟。在完成鼻腔症状问卷后，将局部荧光素喷雾喷入 10 名健康志愿者的鼻腔和口咽，然后在两种情况下进行软性喉镜检查：常规检查，无诱发反应和打喷嚏/咳嗽诱发。之后，在紫外线灯下对术者和参与者身上的飞沫进行计数。在常规喉镜检查后，10 名志愿者中有 1 名观察到飞沫，而在喉镜检查伴有打喷嚏/咳嗽时，有 4 名观察到飞沫。打喷嚏/咳嗽后产生飞沫的患者，基于鼻塞和流涕的鼻腔症状评分显著升高（=0.0164）。术者身上没有观察到飞沫。总体而言，在充分使用个人防护设备的情况下，软性喉镜检查对术者造成的飞沫风险极小。鼻腔症状可以识别出更有可能在打喷嚏/咳嗽后产生飞沫的患者。
