A novel aerosolisation mitigation device for endoscopic sinus and skull base surgery in the COVID-19 era
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RHINOLOGY
A novel aerosolisation mitigation device for endoscopic sinus and skull base surgery in the COVID‑19 era Jaime Viera‑Artiles1 · David Mato2 · José J. Valdiande3 · David Lobo1 · Juan Pedraja4 · José M. López‑Higuera3,5 · Javier Ospina6 Received: 11 September 2020 / Accepted: 28 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To provide a novel solution to reduce aerosol exposure in the operating room during endoscopic sinus and skull base procedures in the COVID-19 era. Methods We have designed a 3D printable midfacial mask that partially seals the nose, while allowing instrumentation during endoscopic transnasal surgery. The mask when connected to a vacuum system creates a constant negative pressure inside it, sucking out aerosols and gases generated during surgical procedures. Its effectiveness was tested using vapour exhalations by a human volunteer and drilling bone in a head model. The physical barrier effect was measured using fluorescein atomization in a head model. Results The pressure and airflow measured remained negative inside it in all the different situations tested. The mask was capable of completely evacuating human adult exhalation, and was more effective than the hand suction instrument. However, it was as effective as hand suction instrument at preventing aerosol spread from bone drilling. The physical barrier effect achieved a 72% reduction in the splatter created from the fluorescein atomization. Conclusions The mask effectively prevented the spread of aerosols and reduced droplet spread during simulated transnasal endoscopic skull base surgery in laboratory conditions. This device has potential benefits in protecting surgical personnel against airborne transmission of COVID-19 and could be useful in reducing chronic exposure to the hazard of surgical smoke. Keywords SARS-CoV-2 · COVID-19 · Endoscopic sinus surgery · Skull base surgery · Infection prevention
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00405-020-06462-1) contains supplementary material, which is available to authorized users. * Jaime Viera‑Artiles [email protected] 1
ENT Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
2
Neurosurgery Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
3
Photonics Engineering Group, Universidad de Cantabria, Santander, Spain
4
Hospital Virtual de Valdecilla, Santander, Spain
5
Centro de Investigacion Biomédica En Red (CIBER‑BBN), Instituto De Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
6
Division of Otolaryngology ‑ Sinus and Skull Base Surgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia
Coronavirus disease 2019 (COVID-19) resulting from the novel coronavirus strain (SARS-CoV-2) represents an extraordinary threat to the health of the world’s population. Different modes of transmission have been described, and all contribute to the exponential growth of the virus wo
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