• Dhruv Sharma, Michael J Ye, Vincent J Campiti, Kolin E Rubel, Thomas S Higgins, Arthur W Wu, Taha Z Shipchandler, Michael W Sim, Sarah J Burgin, Elisa A Illing, Jae Hong Park, and Jonathan Y Ting.
• Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA.
• Otolaryngol Head Neck Surg. 2021 Feb 1; 164 (2): 433-442.

ObjectiveAfter significant restrictions initially due to the COVID-19 pandemic, otolaryngologists have begun resuming normal clinical practice. However, the risk of SARS-CoV-2 transmission to health care workers through aerosolization and airborne transmission during rhinologic surgery remains incompletely characterized. The objective of this study was to quantify the number concentrations of aerosols generated during rhinologic surgery with and without interventions involving 3 passive suction devices.Study DesignCadaver simulation.SettingDedicated surgical laboratory.Subjects And MethodsIn a simulation of rhinologic procedures with and without different passive suction interventions, the concentrations of generated aerosols in the particle size range of 0.30 to 10.0 µm were quantified with an optical particle sizer.ResultsFunctional endoscopic sinus surgery with and without microdebrider, high-speed powered drilling, use of an ultrasonic aspirator, and electrocautery all produced statistically significant increases in concentrations of aerosols of various sizes (P < .05). Powered drilling, ultrasonic aspirator, and electrocautery generated the highest concentration of aerosols, predominantly submicroparticles <1 µm. All interventions with a suction device were effective in reducing aerosols, though the surgical smoke evacuation system was the most effective passive suction method in 2 of the 5 surgical conditions with statistical significance (P < .05).ConclusionSignificant aerosol concentrations were produced in the range of 0.30 to 10.0 µm during all rhinologic procedures in this cadaver simulation. Rhinologic surgery with a passive suction device results in significant mitigation of generated aerosols.

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