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Aerosol and droplet generation through open rhinoplasty: surgical risk in times of pandemic

This article was originally published here

Facial plastic Surg Aesthet Med. 2021 December 29th doi: 10.1089 / fpsam.2021.0157. Online before printing.

ABSTRACT

Introduction: The 2019 coronavirus disease pandemic has raised concerns about the risk of transmission from head and neck surgery, including cosmetic facial surgery. Objectives: To quantify droplet and aerosol generation from rhinoplasty techniques in a human anatomical specimen model using fluorescein staining and an optical particle sizer. Methods: Noses from human anatomical specimens were infiltrated with 0.1% fluorescein. Droplets and aerosols were measured during rhinoplasty techniques including opening of the skin-soft tissue envelope, monopolar electrocautery, endonasal rasps, endonasal osteotomy, and percutaneous osteotomy. Results: No visible droplet contamination was observed in any of the rhinoplasty techniques examined. Compared to the negative control of the anterior rhinoscopy, a total of 0.300-10,000 µm aerosols were increased after monopolar electrocautery (p < 0.001) and endonasal rasp (p = 0.003). Opening the skin-soft tissue envelope, endonasal osteotomies, and percutaneous osteotomies did not generate a detectable increase in aerosols (p > 0.15). Discussion and Conclusions: In this study, no droplets were observed under ultraviolet light, and aerosol formation was only observed with cauterization and endonasal rasping.

PMID: 34964656 | DOI: 10.1089 / fpsam.2021.0157

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