Matos Sophia, Sharma Arun, Crosby Dana
Southern Illinois University School of Medicine, Springfield, Illinois, USA.
Department of Otolaryngology Head and Neck Surgery, Southern Illinois University School of Medicine, Illinois, USA.
Otolaryngol Head Neck Surg. 2022 Sep;167(3):417-424. doi: 10.1177/01945998211050632. Epub 2021 Oct 12.
The goal of this systematic review is to assimilate the literature on objective assessment of particulate aerosolization during transnasal endoscopic procedures.
PubMed and hand-searched articles.
The PubMed electronic database was searched using Medical Subject Headings and free-text search terms relating to aerosolization and transnasal endoscopic procedures from inception to November 16, 2020. References were hand-searched to identify additional publications for consideration. Inclusion in the systematic review required quantification of aerosol generation during clinic transnasal endoscopic procedures. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and flowchart were followed during the systematic review.
Eight of 900 studies met criteria for inclusion in the systematic review. Five studies tested nasal endoscopy with mixed findings on the risk of aerosol generation during this procedure. Two studies assessed flexible fiberoptic laryngoscopy and also reported mixed findings. Breathing, sneezing, speech, and spray anesthetic/decongestants were found to consistently increase aerosol generation above baseline. A number of studies tested new and general mitigation strategies and were found to be effective in decreasing aerosol generation.
The coronavirus disease 2019 pandemic has informed many considerations regarding patient and provider safety. It is valuable to understand the risk during outpatient otolaryngology procedures through the quantification of aerosolization. There are several effective methods to control aerosolization during these procedures. The findings of this systematic review will inform appropriate precautions to protect against spread of infectious agents by aerosolization.
本系统评价的目的是汇总有关经鼻内镜手术中颗粒气溶胶化客观评估的文献。
PubMed及手工检索的文章。
使用医学主题词和与气溶胶化及经鼻内镜手术相关的自由文本检索词，对PubMed电子数据库从建库至2020年11月16日进行检索。对手工检索参考文献以确定其他可供考虑的出版物。纳入本系统评价要求对临床经鼻内镜手术期间的气溶胶生成进行量化。在系统评价过程中遵循系统评价和Meta分析的首选报告项目指南及流程图。
900项研究中有8项符合纳入本系统评价的标准。5项研究对鼻内镜检查进行了测试，在此手术期间气溶胶生成风险的结果不一。2项研究评估了可弯曲纤维喉镜检查，结果也不一。发现呼吸、打喷嚏、说话以及喷雾麻醉剂/减充血剂会持续使气溶胶生成量高于基线水平。多项研究测试了新的和一般的缓解策略，发现这些策略可有效减少气溶胶生成。
2019冠状病毒病大流行引发了许多关于患者和医护人员安全的考量。通过对气溶胶化进行量化来了解门诊耳鼻喉科手术期间的风险很有价值。在这些手术期间有几种有效的方法来控制气溶胶化。本系统评价的结果将为采取适当的预防措施以防止感染性因子通过气溶胶传播提供依据。
