Sithole S P, Kuhn W, Sibiya L A
University of KwaZulu-Natal, Nelson R. Mandela School of Medicine Durban South Africa.
Laryngoscope Investig Otolaryngol. 2024 Jun 4;9(3):e1287. doi: 10.1002/lio2.1287. eCollection 2024 Jun.
The objectives were to determine the surgical modality with the lowest aerosol and droplets generated by commonly used modalities in oropharyngeal and laryngeal surgery.
A simulation of oropharyngeal and laryngeal surgery was set up using fresh sheep heads. Four common surgical modalities were utilized: cold steel, electrocautery, coblation, and microdebrider. The resultant aerosol generated was evaluated using two measurement modalities at two key positions in the theater. (1) DustTrak Pro Aerosol Monitor was used to measure the concentration of particles. (2) Fluorescein dye coated on the oropharynx and larynx, and the resultant scatter on paper.
Electrocautery and coblation produced statistically significant increases in the concentration of aerosols ( < .001). Microdebrider and cold steel instrumentation produced the least aerosols. No measurable fluorescein droplets were noted for all four modalities.
Electrocautery and coblation produced higher concentrations of aerosols. Mitigation factors should be considered with instruments with increased aerosolization. These modalities show low droplet-related infection risk.
确定口咽和喉部手术中常用术式产生气溶胶和飞沫最少的手术方式。
使用新鲜羊头搭建口咽和喉部手术模拟模型。采用四种常见手术方式：冷器械、电灼、低温等离子消融和微型切割器。在手术室的两个关键位置使用两种测量方式评估产生的气溶胶。（1）使用DustTrak Pro气溶胶监测仪测量颗粒浓度。（2）在口咽和喉部涂抹荧光素染料，并测量纸张上产生的散射光。
电灼和低温等离子消融产生的气溶胶浓度有统计学显著增加（<0.001）。微型切割器和冷器械产生的气溶胶最少。所有四种术式均未检测到可测量的荧光素飞沫。
电灼和低温等离子消融产生的气溶胶浓度较高。对于气溶胶化增加的器械，应考虑减轻因素。这些术式显示与飞沫相关的感染风险较低。
