Microdebrider is less aerosol-generating than CO2 laser and cold instruments in microlaryngoscopy.
Eur Arch Otorhinolaryngol
; 279(2): 825-834, 2022 Feb.
Article
in English
| MEDLINE | ID: covidwho-1661679
ABSTRACT
OBJECTIVE:
COVID-19 spreads through aerosols produced in coughing, talking, exhalation, and also in some surgical procedures. Use of CO2 laser in laryngeal surgery has been observed to generate aerosols, however, other techniques, such cold dissection and microdebrider, have not been sufficiently investigated. We aimed to assess whether aerosol generation occurs during laryngeal operations and the effect of different instruments on aerosol production.METHODS:
We measured particle concentration generated during surgeries with an Optical Particle Sizer. Cough data collected from volunteers and aerosol concentration of an empty operating room served as references. Aerosol concentrations when using different techniques and equipment were compared with references as well as with each other.RESULTS:
Thirteen laryngological surgeries were evaluated. The highest total aerosol concentrations were observed when using CO2 laser and these were significantly higher than the concentrations when using microdebrider or cold dissection (p < 0.0001, p < 0.0001) or in the background or during coughing (p < 0.0001, p < 0.0001). In contrast, neither microdebrider nor cold dissection produced significant concentrations of aerosol compared with coughing (p = 0.146, p = 0.753). In comparing all three techniques, microdebrider produced the least aerosol particles.CONCLUSIONS:
Microdebrider and cold dissection can be regarded as aerosol-generating relative to background reference concentrations, but they should not be considered as high-risk aerosol-generating procedures, as the concentrations are low and do not exceed those of coughing. A step-down algorithm from CO2 laser to cold instruments and microdebrider is recommended to lower the risk of airborne infections among medical staff.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Lasers, Gas
/
COVID-19
Type of study:
Experimental Studies
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Eur Arch Otorhinolaryngol
Journal subject:
Otolaryngology
Year:
2022
Document Type:
Article
Affiliation country:
S00405-021-07105-9
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