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Aerosol and Droplet Generation from Open Rhinoplasty: Surgical Risk in the Pandemic Era.

Michael J YeVincent J CampitiMegan FallsLauren A HowserDhruv SharmaRaghav B VadhulSarah J BurginElisa A IllingJonathan Y TingKarl R KoehlerJae Hong ParkDominic J VernonBradley R NesemeierJeffrey D JohnsonTaha Z Shipchandler
Published in: Facial plastic surgery & aesthetic medicine (2021)
Introduction: The coronavirus disease 2019 pandemic has led to concerns over transmission risk from head and neck operations including facial cosmetic surgeries. Objectives: To quantify droplet and aerosol generation from rhinoplasty techniques in a human anatomic specimen model using fluorescein staining and an optical particle sizer. Methods: Noses of human anatomic specimens were infiltrated using 0.1% fluorescein. Droplets and aerosols were measured during rhinoplasty techniques including opening the skin-soft tissue envelope, monopolar electrocautery, endonasal rasping, endonasal osteotomy, and percutaneous osteotomy. Results: No visible droplet contamination was observed for any rhinoplasty techniques investigated. Compared with the negative control of anterior rhinoscopy, total 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 investigation, droplets were not observed under ultraviolet light, and aerosol generation was noted only with cautery and endonasal rasping.
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