Abstract
ObjectiveTo create an aerosol containment mask (ACM) that contains aerosols during common otolaryngologic endoscopic procedures while protecting patients from environmental aerosols.Study DesignBench testing.SettingMannequin testing.MethodsThe mask was designed in SolidWorks and 3-dimensional printed. Mannequins were fitted with a nebulizer to generate aerosols. Commercial particle counters were used to measure mask performance.ResultsThe ACM has 2 ports on either side for instruments and endoscopes, a port for a filter, and a port that can evacuate aerosols contained within the mask via a standard suction pump. The mask contained aerosols on a mannequin with and without facial hair when the suction was set to 18.5 L/min. Other types of masks demonstrated substantial aerosol leakage under similar conditions. In a subsequent experiment, the ACM contained aerosols generated by a nebulizer up to the saturation of the particle detector without measurable leakage with or without suction.ConclusionThe ACM will accommodate rigid and flexible endoscopes plus instruments and prevent leakage of patient-generated aerosols, thus avoiding contamination of the room and protecting health care workers from airborne contagions.Level of evidence2.
Highlights
Aerosolized particles \5 mm may remain viable in the air for at least 3 hours.[6]
While one study found that laryngoscopy alone may not generate aerosols greater than that produced by breathing, laryngoscopy and nasal endoscopy are associated with increased risk of coughing and sneezing, which are aerosol-generating events.[7,8]
Patients wear a surgical mask over their mouths during nasal endoscopy, a regular surgical mask is insufficient to protect at close range against all particle transmission generated by simulated aerosol generation.[8]
Summary
The mask was designed in SolidWorks and 3-dimensional printed. Mannequins were fitted with a nebulizer to generate aerosols. Commercial particle counters were used to measure mask performance. The study was approved by the University of Southern California Institutional Review Board (HS-20-00482). We created multiple design iterations by using SolidWorks (Dassault Systemes) and printing on a 3D printer (Ultimaker) with tough PLA (polylactic acid; Ultimaker). We tested initial prototypes on endoscopic surgery model heads to gauge access to the nasal cavity and ability to contain aerosols. The design was modified as issues were identified. The main considerations during the design phase were to appropriately position the blind grommet, find a gel cushion to seal the mask to various face shapes, and create a way to attach an replaceable HEPA filter (high-efficiency particulate air).
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