A Negative-Pressure Face-Mounted System Reduces Aerosol Spread during Endonasal Endoscopic Surgery

Area of Science:

• Otolaryngology
• Infectious Disease Control
• Surgical Technology

Background:

• Endonasal surgeries pose a risk of COVID-19 transmission due to potential droplet and aerosol generation.
• Minimizing airborne particles during surgical procedures is crucial for patient and healthcare worker safety.

Purpose of the Study:

• To evaluate methods for reducing droplet and aerosol generation during endoscopic endonasal surgery.
• To assess the efficacy of a novel face-mounted negative-pressure mask in controlling airborne contaminants.

Main Methods:

• Droplet spread was assessed using fluorescence detection.
• Aerosol density (<10 µm) was measured with a photometric particle counter.
• A randomized controlled trial compared a negative-pressure mask group with a no-mask group, using continuous suction and irrigation.

Main Results:

• Aerosol density increased during sphenoid drilling in both groups when suction and irrigation were used.
• Interruption of suction and irrigation significantly increased aerosol density in the no-mask group.
• The negative-pressure mask demonstrated additional safety benefits, particularly when suction was inadvertently blocked.

Conclusions:

• Aerosol generation during endonasal drilling is a significant concern, especially during pandemics.
• Rigid suction and copious irrigation are effective in reducing aerosol spread.
• A negative-pressure mask offers supplementary protection against aerosol transmission in endonasal surgery.