About: INTRODUCTION: COVID‐19 has significantly impacted endonasal surgery, and recent experimentation has demonstrated that sinonasal drilling and cautery have significant propensity for airborne particulate generation immediately adjacent to the surgical field. In the present investigation, we assess nasopharyngeal suctioning as a mitigation strategy to decrease particulate spread during simulated endonasal surgical activity. METHODS: Airborne particulate generation in the 1‐10μm range was quantified with an optical particle sizer in real‐time during cadaveric‐simulated anterior and posterior endonasal drilling and cautery conditions. To test suction mitigation, experiments were performed both with and without a rigid suction placed in the contralateral nostril, terminating in the nasopharynx. RESULTS: Both anterior (medial maxillary wall and nasal septum) and posterior (sphenoid rostrum) drilling produced significant particulate generation in the 1‐10μm range throughout the duration of drilling (p<0.001) without the use of suction, while nasopharyngeal suction use eliminated the detection of generated airborne particulate. A similar effect was seen with nasal cautery, with significant particle generation (p<0.001) that was reduced to undetectable levels with the use of nasopharyngeal suction. CONCLUSIONS: The use of nasopharyngeal suctioning via the contralateral nostril minimizes airborne particulate spread during simulated sinonasal drilling and cautery. In the era of COVID‐19, this technique offers an immediately available measure that may increase surgical safety. This article is protected by copyright. All rights reserved   Goto Sponge  NotDistinct  Permalink

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  • INTRODUCTION: COVID‐19 has significantly impacted endonasal surgery, and recent experimentation has demonstrated that sinonasal drilling and cautery have significant propensity for airborne particulate generation immediately adjacent to the surgical field. In the present investigation, we assess nasopharyngeal suctioning as a mitigation strategy to decrease particulate spread during simulated endonasal surgical activity. METHODS: Airborne particulate generation in the 1‐10μm range was quantified with an optical particle sizer in real‐time during cadaveric‐simulated anterior and posterior endonasal drilling and cautery conditions. To test suction mitigation, experiments were performed both with and without a rigid suction placed in the contralateral nostril, terminating in the nasopharynx. RESULTS: Both anterior (medial maxillary wall and nasal septum) and posterior (sphenoid rostrum) drilling produced significant particulate generation in the 1‐10μm range throughout the duration of drilling (p<0.001) without the use of suction, while nasopharyngeal suction use eliminated the detection of generated airborne particulate. A similar effect was seen with nasal cautery, with significant particle generation (p<0.001) that was reduced to undetectable levels with the use of nasopharyngeal suction. CONCLUSIONS: The use of nasopharyngeal suctioning via the contralateral nostril minimizes airborne particulate spread during simulated sinonasal drilling and cautery. In the era of COVID‐19, this technique offers an immediately available measure that may increase surgical safety. This article is protected by copyright. All rights reserved
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