Sharma Dhruv, Campiti Vincent J, Ye Michael J, Saltagi Mohamad, Carroll Aaron E, Ting Jonathan Y, Illing Elisa A, Park Jae Hong, Nelson Rick F, Burgin Sarah J
Department of Otolaryngology - Head & Neck Surgery Indiana University School of Medicine Indianapolis Indiana USA.
School of Medicine Indiana University Indianapolis Indiana USA.
Laryngoscope Investig Otolaryngol. 2020 Dec 16;6(1):129-136. doi: 10.1002/lio2.506. eCollection 2021 Feb.
The risk of SARS-CoV-2 transmission to healthcare workers through airborne aerosolization during otologic surgery has not been characterized. The objective of this study was to describe and quantify the aerosol generation during common otologic procedures in both cadaveric surgical simulation and live patient surgery.
The number concentrations of generated aerosols in the particle size range of 0.30 to 10.0 μm were quantified using an optical particle sizer during both a cadaveric simulation of routine otologic procedures as well as cochlear implant surgery on live patients in the operating room.
In the cadaveric simulation, temporalis fascia graft harvest using cold techniques (without electrocautery) (n = 4) did not generate aerosols above baseline concentrations. Tympanoplasty (n = 3) and mastoidectomy (n = 3) both produced statistically significant increases in concentrations of aerosols ( < 0.05), predominantly submicron particles (< 1.0 μm). High-speed, powered drilling of the temporal bone during mastoidectomy with a Multi Flute cutting burr resulted in higher peak concentrations and greater number of spikes in aerosols than with a diamond burr. In the operating room, spikes in aerosols occurred during both cochlear implant surgeries.
In the cadaveric simulation, temporalis fascia graft harvest without electrocautery did not generate aerosol levels above baseline, while significant aerosol levels were generated during mastoidectomy and to a much less degree during tympanoplasty. Aerosol spikes were appreciated during cochlear implantation surgery in live patients.
耳科手术期间严重急性呼吸综合征冠状病毒2（SARS-CoV-2）通过空气雾化传播给医护人员的风险尚未明确。本研究的目的是描述和量化在尸体手术模拟和活体患者手术中常见耳科手术过程中产生的气溶胶。
在尸体模拟常规耳科手术以及手术室中对活体患者进行人工耳蜗植入手术期间，使用光学粒子计数器对粒径范围为0.30至10.0μm的生成气溶胶的数量浓度进行量化。
在尸体模拟中，采用冷技术（无电灼）采集颞肌筋膜移植物（n = 4）未产生高于基线浓度的气溶胶。鼓室成形术（n = 3）和乳突根治术（n = 3）均使气溶胶浓度产生统计学显著增加（<0.05），主要是亚微米颗粒（<1.0μm）。与使用金刚石磨头相比，在乳突根治术中使用多刃切割磨头高速动力钻磨颞骨导致气溶胶的峰值浓度更高且峰值数量更多。在手术室中，两次人工耳蜗植入手术期间均出现了气溶胶峰值。
在尸体模拟中，无电灼采集颞肌筋膜移植物未产生高于基线的气溶胶水平，而乳突根治术期间产生了显著的气溶胶水平，鼓室成形术期间产生的气溶胶水平则低得多。在活体患者人工耳蜗植入手术期间观察到了气溶胶峰值。
2级。
