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Updated: Dec 9, 2025
Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
Minimising aerosol spread during endoscopic sinus and skull base surgery. Experimental model evaluation of the
D Ioannidis1, A Tsagkovits1, A Rokade1
1ENT Department, Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust, Winchester, UK.
Background:
Endoscopic sinus and anterior skull base surgery is considered particularly high risk for severe acute respiratory syndrome coronavirus-2 transmission in the operating theatre setting. In this context, the use of a microscope drape method is proposed, to minimise aerosol spread in the wider operating theatre environment.
Methods:
The efficacy of the method is assessed with a simulation model, using a CMI Concept Air Trace MK2 smoke generator for aerosol generation and a Fluke 985 air particle counter to measure air particles sized 0.3-10 μm in the operating theatre environment.
Results:
Aerosol spread was contained almost to baseline levels with the application of the drape barrier and the negative pressure created using suction within the drape.
Conclusion:
The method is an efficient adjunct that could reduce the risk of aerosol shedding and viral transmission to the operating theatre team. It potentially allows faster operating theatre turnover and more liberal use of powered instruments during endonasal surgery.
Insights
A novel microscope drape method effectively minimizes aerosol spread during endoscopic sinus and skull base surgery, significantly reducing severe acute respiratory syndrome coronavirus-2 transmission risks for operating theatre teams.
Area of Science:
- Surgical Innovation
- Infection Control
- Respiratory Medicine
Background:
- Endoscopic sinus and anterior skull base surgery pose high risks for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission.
- Aerosol generation during these procedures can contaminate the operating theatre environment.
Purpose of the Study:
- To evaluate a microscope drape method designed to minimize aerosol spread.
- To assess the efficacy of this method in reducing viral transmission during high-risk surgeries.
Main Methods:
- A simulation model was employed to assess the drape method's efficacy.
- Aerosol generation was simulated using a smoke generator.
- Air particle counts (0.3-10 μm) were measured using an air particle counter.
Main Results:
- The microscope drape method, combined with suction-generated negative pressure, contained aerosol spread to near baseline levels.
- Significant reduction in airborne particles was observed within the operating theatre environment.
Conclusions:
- The microscope drape method is an effective adjunct for reducing aerosol shedding and viral transmission risk to surgical teams.
- This technique may enable faster operating theatre turnover and increased use of powered instruments in endonasal surgery.
