Temporal bone dissection: a possible route for prion transmission?

Abstract

The aim of this study was to determine whether neural tissue is present in the bone 'dust' given off during temporal bone drilling. Bone 'dust' from three temporal bone dissections was collected and examined. Evidence of neural tissue was present in two out of the three specimens. Neural tissue is present in the bone dust given off during temporal bone drilling. This poses the question as to the risk of prion transmission during such dissection.

Review of temporal bone dissection teaching: how it was, is and will be

“…6 They demonstrated microscopic evidence of neural tissue in the cloud of bone dust created during such drilling. Many surgeons now wear eye protection during surgery, but this precaution must also be used in cadaveric temporal bone laboratories (amongst other precautions to reduce infection risk).…”

Biofouling of surgical power tools during routine use

“…49 Bone dust contamination during temporal bone dissection has been shown to contain neurological material, indicating the potential for contamination with prion protein. 59 Orthopaedic shavers have also been shown to harbour potentially infective material even after decontamination. An evaluation by Kobayashi et al using energy-dispersive X-ray analysis, Fourier transform infrared spectroscopy and Auger microscopy revealed collagen and hydroxyl proteins on arthroscopic blades after decontamination by high-pressure water flow, ultrasonic cleaning, and sterilization using ethylene oxide.…”

Creutzfeldt–Jakob disease and ENT

“…Even when dura and the facial nerve were avoided, neural tissue was detected in the bone dust in two out of three specimens. 38 This raises the possibility of potential prion transmission in an aerosolised form; however, this research needs to be extended as regards sample numbers and evaluation of whether prions are actually present in the sample material. Even so, such research could potentially call into question the use of reusable drill burrs.…”