Which of the following procedures does not produce significant airborne aerosol generation during surgical and clinical simulation?

A) Microdebridement
B) Suction drilling at 12,000 rpm
C) High-speed drilling at 70,000 rpm
D) Transnasal cautery
E) All of the above produce significant airborne aerosolization

View Answer

Answer: Microdebridement

In the era of SARS-CoV-2, the risk of infectious airborne aerosol generation during otolaryngologic procedures has been an area of increasing concern. The objective of this investigation was to quantify airborne aerosol production under clinical and surgical conditions. They used airborne aerosol quantification with an optical particle sizer that was performed in real time during cadaveric simulated endoscopic surgical conditions, including hand instrumentation, microdebrider use, high-speed drilling, and cautery. Their results were that hand instrumentation and microdebridement did not produce detectable airborne aerosols in the range of 1 to 10 μm, while suction drilling at 12,000 rpm, high-speed drilling at 70,000 rpm, and transnasal cautery generated significant airborne aerosols.

Airborne Aerosol Generation During Endonasal Procedures in the Era of COVID-19: Risks and Recommendations. Alan D Workman, Aria Jafari, D Bradley Welling, et al. Otolaryngol Head Neck Surg. 2020 Sep;163(3):465-470.

Analysis: Less than one third of otolaryngologists answered correctly.

Which of the following procedures does not produce significant airborne aerosol generation during surgical and clinical simulation?

Airborne aerosol generation in endonasal procedures

The most popular answer among otolaryngologists was All of the Above at 46%, while the correct answer, Microdebridement, was the second most selected answer at 31%. Transnasal cautery was answered by 19% of head and neck surgeons while both suction drilling and high speed drilling were selected only 2% and 1% of the time respectively.

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