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Aerosol and Droplet Generation from Open Rhinoplasty: Surgical Risk in the Pandemic Era.
Michael J Ye1, Vincent J Campiti1, Megan Falls1
1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Facial Plastic Surgery & Aesthetic Medicine
|December 29, 2021
Summary
Rhinoplasty procedures did not produce visible droplets. Aerosol generation was only observed during monopolar electrocautery and endonasal rasping, indicating minimal transmission risk from these specific techniques.
Area of Science:
- Otolaryngology
- Plastic Surgery
- Infectious Disease Control
Background:
- The COVID-19 pandemic raised concerns about surgical transmission risks, particularly for head and neck procedures like facial cosmetic surgeries.
- Understanding aerosol and droplet generation during rhinoplasty is crucial for patient and healthcare worker safety.
Purpose of the Study:
- To quantitatively assess droplet and aerosol production during various rhinoplasty techniques.
- To evaluate the potential for viral transmission during these procedures.
Main Methods:
- Utilized a human anatomic specimen model with fluorescein staining.
- Measured droplet and aerosol generation using an optical particle sizer during specific rhinoplasty steps.
- Included techniques such as skin-soft tissue envelope opening, electrocautery, rasping, and osteotomy.
Main Results:
- No visible droplets were detected from any tested rhinoplasty techniques.
- A significant increase in aerosols (0.300-10.000 μm) was observed following monopolar electrocautery and endonasal rasping.
- Opening the skin-soft tissue envelope, endonasal osteotomies, and percutaneous osteotomies did not significantly increase aerosol generation.
Conclusions:
- Rhinoplasty techniques, excluding cautery and rasping, do not appear to generate significant aerosolized particles.
- The study suggests a low risk of droplet transmission during most rhinoplasty procedures.
- Cautery and endonasal rasping warrant specific precautions due to observed aerosol generation.
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