To the Editor, In a recent publication by Workman et al., 1 the authors examine spread of fluorescent particles during a range of endonasal procedures using a cadaver model and propose guidance on risk of aerosolization with these procedures. This study was designed to measure droplet spread, not aerosol deposition or settling. Infectious aerosols are defined as particles under 100 µm in diameter that are suspended in a gas and can be respired. 2,3 Aerosol particles between 10 and 100 µm tend to deposit in the upper airway whereas particles under 5 to 10 µm in size are the airborne particles that can bypass the upper airway and penetrate deep into the lungs. 2,4,5 Aerosol movement, deposition, and surface settling times are generally influenced by air flow rates in the local environment. 2,4 Simulation of aerosol movement in an exam room demonstrated that aerosol can spread throughout the room within 5 minutes and aerosol clearance is highly dependent on the number of air changes per hour. 6 These fundamental properties of aerosols together with characteristic spread patterns for droplets form the basis for guidelines for personal protective equipment (PPE) use for airborne vs droplet precautions. 3 Workman et al. 1 used an atomizer to create a fluorescent layer of particles ranging in size from 30 to 100 µm in diameter. However, the particles produced during the simulation of aerosol generation by the atomizer alone and during the endoscopic procedures are not limited to this size. The fluorescent particles can attach to other larger particles through hydrostatic forces, including moisture inside the cadaver, or random-sized particles generated by the described endoscopic procedures. These aggregate particles are then expelled from the nose as droplets based on the velocity of the initial spray or net velocity of air movement generated by the endoscopic procedure. This is supported by the results of Figure 3A in Workman et al. 1 In Figure 3A, the size of particles detected outside the model system after expulsion of fluorescent particles generated by the atomizer are in the range of hundreds of microns to about 1500 µm in size, well outside the defined range of infectious aerosols,