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Is Office Laryngoscopy an Aerosol-Generating Procedure?
Anaïs Rameau1, Mark Lee1, Necati Enver1,2
1The Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, New York, U.S.A.
The Laryngoscope
|July 17, 2020
Summary
Office laryngoscopy does not appear to be an aerosol-generating procedure. This study used an optical particle sizer (OPS) to measure aerosols during simulated laryngoscopy, finding no significant generation above breathing or phonation.
Area of Science:
- Otolaryngology
- Respiratory Medicine
- Infectious Disease Control
Background:
- Office laryngoscopy is a common otolaryngological procedure.
- Understanding aerosol generation is crucial for infection control, especially during respiratory procedures.
- Previous assessments of aerosol generation in medical interventions have varied in methodology.
Purpose of the Study:
- To determine if office laryngoscopy is an aerosol-generating procedure (AGP) using an optical particle sizer (OPS).
- To quantify aerosol and droplet generation during simulated rigid and flexible laryngoscopy.
- To critically evaluate methods for assessing the aerosolizing potential of invasive interventions.
Main Methods:
- Prospective quantification of aerosol and droplet generation during simulated rigid and flexible laryngoscopy in two healthy volunteers.
- An OPS measured particle counts (0.3 to >10 μm) at 12 cm from the subject's airway.
- Interventions included breathing, speech, and various phonation tasks, alongside flexible and rigid laryngoscopy.
Main Results:
- Laryngoscopy interventions did not generate aerosols above levels produced by breathing or phonation.
- Breathing and /ae/ phonation were statistically significant producers of aerosols and droplets.
- Speech and /e/ phonation did not show statistically significant aerosol or droplet generation.
Conclusions:
- Office laryngoscopy is unlikely to be an aerosol-generating procedure based on OPS measurements.
- Optical particle sizers have limitations for assessing droplet distribution in such procedures.
- Further studies employing more sophisticated droplet measurement methods are recommended.
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