Aerosol generation with common rhinologic devices: cadaveric study conducted in a surgical suite

LeConte, Bailey; Low, Garren; Citardi, Martin J.; Yao, William C.; Eguia, Arturo; Luong, Amber U.

doi:10.1002/alr.22679

Cited by 9 publications

(18 citation statements)

References 5 publications

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“…However, the implications of these findings on viral transmissibility, replicativity, and their designation as “aerosol generating procedures (AGPs)” remain controversial 122–127 . Both high‐speed drill and bipolar electrocautery are considered aerosol‐generating devices, and are often required in extended surgical approaches for recalcitrant CRS 123,128 . The use of constant suctioning during these procedures may help mitigate particle transmission 122,125 .…”

Section: Introductionmentioning

confidence: 99%

“…The use of constant suctioning during these procedures may help mitigate particle transmission 122,125 . Notably the microdebrider, with its in‐line suction, does not appear to be a significant aerosol producer 123,128 . Other aerosol‐generating in‐office devices include bipolar RF ablation (coblation) and cryotherapy, both used for treatment of rhinitis 128 .…”

Section: Introductionmentioning

confidence: 99%

“…Notably the microdebrider, with its in‐line suction, does not appear to be a significant aerosol producer 123,128 . Other aerosol‐generating in‐office devices include bipolar RF ablation (coblation) and cryotherapy, both used for treatment of rhinitis 128 . The infectious transmission risk of diagnostic nasal endoscopy remains another area of active investigation.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

Self Cite

455

479

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

Self Cite

455

479

View full text Add to dashboard Cite

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“…Die parallele Absaugung (z. B. durch die kontralaterale Nase) wurde zur Verringerung der Aerosolbelastung empfohlen [ 24 ]. Otochirurgie Da das Mittelohr und das Mastoid mit dem Nasenrachen verbunden sind, stehen diese Strukturen im Verdacht, mit SARS-CoV‑2 besiedelt zu sein.…”

Section: Aerosolexposition Und Infektionsrisiken Bei Hals-nasen-ohrenunclassified

“…Die parallele Absaugung (z. B. durch die kontralaterale Nase) wurde zur Verringerung der Aerosolbelastung empfohlen [ 24 ].…”

Section: Aerosolexposition Und Infektionsrisiken Bei Hals-nasen-ohrenunclassified

Das erste Jahr der Pandemie mit SARS-CoV-2 – Auswirkungen auf die Hals-Nasen-Ohren-Heilkunde

Herzog

Beule

Lüers

et al. 2021

HNO

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Hintergrund Das erste Jahr der Pandemie mit dem Erreger SARS-CoV‑2 („severe acute respiratory syndrome coronavirus 2“) hat unser Gesundheitssystem bereits stark verändert und wird dies auch weiterhin tun. Durch die erhöhte Virusexposition in der Schleimhaut der oberen Luftwege scheinen HNO-ÄrztInnen besonders gefährdet zu sein, sich zu infizieren. Die vorliegende Übersichtsarbeit soll die Auswirkungen auf die HNO-Heilkunde darstellen und eine Einschätzung des Infektionsrisikos für HNO-ÄrztInnen geben. Methoden Es erfolgte eine Recherche in den Datenbanken PubMed, medRxiv und bioRxiv sowie im Deutschen Ärzteblatt und auf den Websites des Robert Koch-Instituts und der Johns Hopkins University nach den einschlägigen deutschen und englischen Fachtermini im Bereich HNO, SARS-CoV‑2, Risiko und Infektion. Ergebnisse Schutzempfehlungen für HNO-Ärzte beinhalten neben den allgemeinen Hygieneregeln das konsequente Tragen von höherwertigen Masken (FFP2/3) in der Routinetätigkeit. Bei Kontakt zu Patienten mit COVID-19 („coronavirus disease 2019“) wird empfohlen, diese Schutzausrüstung um Augenschutz, Kittel, Handschuhe und Haube zu erweitern. Es liegen Empfehlungen internationaler HNO-Fachgesellschaften für bestimmte HNO-ärztliche Tätigkeiten vor (z. B. Tracheotomie, NNH-Chirurgie), wobei neben dem Schutz des Op.-Teams die Reduktion der Aerosolausbreitung essenziell ist. Eine Testung des medizinischen Personals und der Patienten auf SARS-CoV‑2 kann helfen, das Infektionsrisiko zu verringern. Durch eine Impfung würde eine zusätzliche Sicherheit für HNO-Ärzte, die einer erhöhten Aerosolexposition ausgesetzt sind, entstehen. Nach vorliegenden Daten scheinen HNO-ÄrztInnen hinsichtlich eines Infektionsrisikos zu den besonders stark gefährdeten Berufsgruppen zu gehören. Schlussfolgerung Der konsequente Eigenschutz, häufige Testungen von Patienten und Therapeuten und die in Aussicht gestellte Impfung gegen SARS-CoV‑2 können einen adäquaten Schutz für besonders exponierte Berufsgruppen bieten.

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Outcomes 12 Months After Temperature-Controlled Radiofrequency Device Treatment of the Nasal Valve for Patients With Nasal Airway Obstruction

Han

Silvers²,

Rosenthal

et al. 2022

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Nasal valve collapse is a primary cause of nasal airway obstruction (NAO). Patients with NAO and nasal valve collapse experience a variety of symptoms that lower their quality of life, such as nasal congestion, headache, sleep disturbance, daytime sleepiness, and snoring. OBJECTIVE To determine if active treatment of the nasal valve with a temperature-controlled radiofrequency (TCRF) device, previously demonstrated superior to a sham procedure at 3 months, was safe and associated with sustained improvements in symptoms of NAO through 12 months.DESIGN, SETTING, AND PARTICIPANTS In a prospective, multicenter, single-blinded, randomized clinical trial, patients in 16 centers in the US with index procedures between August and December 2020 were assigned to TCRF device treatment of the nasal valve or a sham control procedure (no RF energy). Patients had a baseline Nasal Obstruction Symptom Evaluation (NOSE) Scale score of 55 or greater with nasal valve collapse as the primary or substantial contributor to NAO. After primary end point evaluation at 3 months, eligible patients in the sham control arm crossed over to active treatment. Data analysis was performed between April and May 2022.INTERVENTIONS Patients were treated bilaterally with the TCRF device at 4 or fewer nonoverlapping areas on the nasal mucosa at the junction of the upper and lower lateral cartilage on the lateral nasal wall. MAIN OUTCOMES AND MEASURESThe primary end point measure was responder rate, defined as 20% or greater reduction in NOSE Scale score or 1 or greater reduction in NOSE Scale clinical severity category.RESULTS A total of 108 patients received active treatment (77 as index active treatment, 31 after crossover). The mean (SD) age of patients was 48.5 (12.3) years; 66 (61.1%) were women. The combined group of patients receiving active treatment had a mean baseline NOSE Scale score of 76.3 (95% CI,. At 12 months (n = 88), the responder rate was 89.8% (95% CI, 81.7%-94.5%). The NOSE Scale score improved from baseline (mean change, −44.9 [95% CI, −52.1 to −37.7]). No device/procedure-related serious adverse events were reported. CONCLUSIONS AND RELEVANCEIn this follow-up of a cohort from a randomized clinical trial, the minimally invasive TCRF device, previously demonstrated to be superior to a sham procedure, was safe and associated with improvement in symptoms of NAO through 12 months postprocedure.

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Aerosol generation with common rhinologic devices: cadaveric study conducted in a surgical suite

Cited by 9 publications

References 5 publications

International consensus statement on allergy and rhinology: rhinosinusitis 2021

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Das erste Jahr der Pandemie mit SARS-CoV-2 – Auswirkungen auf die Hals-Nasen-Ohren-Heilkunde

Outcomes 12 Months After Temperature-Controlled Radiofrequency Device Treatment of the Nasal Valve for Patients With Nasal Airway Obstruction

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