Otol Neurotol. 2022 Sep 1;43(8):924-930. doi: 10.1097/MAO.0000000000003591. Epub 2022 Jul 28.
To assess whether aerosol generation occurs during otologic surgery, to define which instruments are aerosol generating, and to identify factors that enhance safety in protection against airborne pathogens, such as severe acute respiratory syndrome coronavirus 2.
An observational prospective study on aerosol measurements during otologic operations recorded between August and December 2020.
Aerosol generation was measured with an Optical Particle Sizer as part of otologic operations with anesthesia. Particles with a size range of 0.3 to 10 μm were quantified. Aerosol generation was measured during otologic operations to analyze aerosols during drilling in transcanal and transmastoid operations and when using the following instruments: bipolar electrocautery, laser, suction, and cold instruments. Coughing is known to produce significant concentration of aerosols and is commonly used as a reference for high-risk aerosol generation. Thus, the operating room background concentration and coughing were chosen as reference values.
Thirteen otologic operations were included. The average drilling time per surgery was 27.00 minutes (range, 2.00-71.80 min).
Different rotation speeds during drilling and other instruments were used.
Aerosol concentrations during operations were recorded and compared with background and cough aerosol concentrations.
Total aerosol concentrations during drilling were significantly higher than background ( p < 0.0001, d = 2.02) or coughing ( p < 0.0001, d = 0.50). A higher drilling rotation speed was associated with higher particle concentration ( p = 0.037, η2 = 0.01). Aerosol generation during bipolar electrocautery, drilling, and laser was significantly higher than with cold instruments or suction ( p < 0.0001, η2 = 0.04).
High aerosol generation is observed during otologic surgery when drill, laser, or bipolar electrocautery is used. Aerosol generation can be reduced by using cold instruments instead of electric and keeping the suction on during aerosol-generating procedures. If drilling is required, lower rotation speeds are recommended. These measures may help reduce the spread of airborne pathogens during otologic surgery.
评估耳科学手术过程中是否会产生气溶胶，并确定哪些器械会产生气溶胶，以及识别在保护免受空气传播病原体（如严重急性呼吸综合征冠状病毒 2 型）方面增强安全性的因素。
这是一项于 2020 年 8 月至 12 月期间进行的关于耳科学手术中气溶胶测量的观察性前瞻性研究。
在麻醉下进行耳科手术时，使用光学粒子计数器测量气溶胶生成。对 0.3 至 10μm 大小范围内的颗粒进行量化。测量耳科学手术中的气溶胶生成情况，以分析经耳道和经乳突手术中钻头、双极电凝、激光、抽吸和冷器械使用过程中的气溶胶。众所周知，咳嗽会产生大量的气溶胶，通常被用作高风险气溶胶产生的参考。因此，选择手术室背景浓度和咳嗽作为参考值。
纳入 13 例耳科学手术。每例手术的平均钻孔时间为 27.00 分钟（范围：2.00-71.80 分钟）。
在钻孔和其他器械使用过程中采用不同的旋转速度。
记录手术过程中的气溶胶浓度，并与背景和咳嗽气溶胶浓度进行比较。
与背景（ p < 0.0001， d = 2.02）或咳嗽（ p < 0.0001， d = 0.50）相比，钻孔过程中的总气溶胶浓度显著升高。更高的钻头旋转速度与更高的颗粒浓度相关（ p = 0.037， η 2 = 0.01）。与冷器械或抽吸相比，双极电凝、钻孔和激光过程中的气溶胶生成明显更高（ p < 0.0001， η 2 = 0.04）。
在使用钻头、激光或双极电凝进行耳科学手术时，会观察到高气溶胶生成。使用冷器械代替电动器械，并在产生气溶胶的过程中保持抽吸，可以减少气溶胶生成。如果需要钻孔，建议降低旋转速度。这些措施可能有助于减少耳科学手术过程中空气传播病原体的传播。
Zotero 插件
