Abstract
ObjectiveThe 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 DesignCadaver simulation series.SettingDedicated surgical laboratory.MethodsTwo 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.ResultsThere 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.ConclusionOur 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.
Highlights
There were no fluorescein droplets or splatter contamination observed in the measured surgical field in any direction after myringotomy and insertion of ventilation tube
Our results show that there is no droplet generation during myringotomy with ventilation tube placement in an operating room setting
No observable fluorescein droplets were noted in the measured surgical field in any direction after myringotomy and insertion of ventilation tube
Summary
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. A middle cranial fossa (MCF) approach was performed bilaterally on both specimens to expose the floor of the MCF. After the MCF floor was completely exposed, a 4-mm port was drilled into the middle ear through the tegmen. The 1 mg/mL fluorescein solution was instilled with a 14-gauge angiocath through the port into the middle ear space (Figure 1A). The presence of fluorescein in the middle ear space was confirmed endoscopically by visualization through the external auditory canal (Figure 1B)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
