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2020 ; 163
(2
): 320-324
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Cadaveric Simulation of Otologic Procedures: An Analysis of Droplet Splatter
Patterns During the COVID-19 Pandemic
#MMPMID32423287
Sharma D
; Rubel KE
; Ye MJ
; Campiti VJ
; Carroll AE
; Ting JY
; Illing EA
; Burgin SJ
Otolaryngol Head Neck Surg
2020[Aug]; 163
(2
): 320-324
PMID32423287
show ga
OBJECTIVE: The otolaryngology community has significant concerns regarding the
spread of SARS-CoV-2 through droplet contamination and viral aerosolization
during head and neck examinations and procedures. The objective of this study was
to investigate the droplet and splatter contamination from common otologic
procedures. STUDY DESIGN: Cadaver simulation series. SETTING: Dedicated surgical
laboratory. METHODS: Two cadaver heads were prepped via bilateral middle cranial
fossa approaches to the tegmen (n = 4). Fluorescein was instilled through a 4-mm
burr hole drilled into the middle cranial fossa floor, and presence in the middle
ear was confirmed via microscopic ear examination. Myringotomy with ventilation
tube placement and mastoidectomy were performed, and the distribution and
distance of resulting droplet splatter patterns were systematically evaluated.
RESULTS: There were no fluorescein droplets or splatter contamination observed in
the measured surgical field in any direction after myringotomy and insertion of
ventilation tube. Gross contamination from the surgical site to 6 ft was noted
after complete mastoidectomy, though, when performed in standard fashion.
CONCLUSION: Our results show that there is no droplet generation during
myringotomy with ventilation tube placement in an operating room setting.
Mastoidectomy, however, showed gross contamination 3 to 6 ft away in all
directions measured. Additionally, there was significantly more droplet and
splatter generation to the left of the surgeon when measured at 1 and 3 ft as
compared with all other measured directions.