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Browsing by Author "Park, Jae Hong"
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Item Aerosol generation during cadaveric simulation of otologic surgery and live cochlear implantation(Wiley, 2021-02) Sharma, Dhruv; Campiti, Vincent J.; Ye, Michael J.; Saltagi, Mohamad; Carroll, Aaron E.; Ting, Jonathan Y.; Illing, Elisa A.; Park, Jae Hong; Nelson, Rick F.; Burgin, Sarah J.; Otolaryngology -- Head and Neck Surgery, School of MedicineObjective The risk of SARS‐CoV‐2 transmission to healthcare workers through airborne aerosolization during otologic surgery has not been characterized. The objective of this study was to describe and quantify the aerosol generation during common otologic procedures in both cadaveric surgical simulation and live patient surgery. Methods The number concentrations of generated aerosols in the particle size range of 0.30 to 10.0 μm were quantified using an optical particle sizer during both a cadaveric simulation of routine otologic procedures as well as cochlear implant surgery on live patients in the operating room. Results In the cadaveric simulation, temporalis fascia graft harvest using cold techniques (without electrocautery) (n = 4) did not generate aerosols above baseline concentrations. Tympanoplasty (n = 3) and mastoidectomy (n = 3) both produced statistically significant increases in concentrations of aerosols (P < 0.05), predominantly submicron particles (< 1.0 μm). High‐speed, powered drilling of the temporal bone during mastoidectomy with a Multi Flute cutting burr resulted in higher peak concentrations and greater number of spikes in aerosols than with a diamond burr. In the operating room, spikes in aerosols occurred during both cochlear implant surgeries. Conclusion In the cadaveric simulation, temporalis fascia graft harvest without electrocautery did not generate aerosol levels above baseline, while significant aerosol levels were generated during mastoidectomy and to a much less degree during tympanoplasty. Aerosol spikes were appreciated during cochlear implantation surgery in live patients.Item Mitigation of Aerosols Generated During Rhinologic Surgery: A Pandemic-Era Cadaveric Simulation(SAGE Publications, 2020-08-11) Sharma, Dhruv; Ye, Michael J.; Campiti, Vincent J.; Rubel, Kolin E.; Higgins, Thomas S.; Wu, Arthur W.; Shipchandler, Taha Z.; Sim, Michael W.; Burgin, Sarah J.; Illing, Elisa A.; Park, Jae Hong; Ting, Jonathan Y.; Otolaryngology -- Head and Neck Surgery, School of MedicineObjective: After significant restrictions initially due to the COVID-19 pandemic, otolaryngologists have begun resuming normal clinical practice. However, the risk of SARS-CoV2 transmission to health care workers through aerosolization and airborne transmission during rhinologic surgery remains incompletely characterized. The objective of this study was to quantify the number concentrations of aerosols generated during rhinologic surgery with and without interventions involving 3 passive suction devices. Study Design: Cadaver simulation. Setting: Dedicated surgical laboratory. Subjects and Methods: In a simulation of rhinologic procedures with and without different passive suction interventions, the concentrations of generated aerosols in the particle size range of 0.30 to 10.0 mm were quantified with an optical particle sizer. Results: Functional endoscopic sinus surgery with and without microdebrider, high-speed powered drilling, use of an ultrasonic aspirator, and electrocautery all produced statistically significant increases in concentrations of aerosols of various sizes (P \.05). Powered drilling, ultrasonic aspirator, and electrocautery generated the highest concentration of aerosols, predominantly submicroparticles \1 mm. All interventions with a suction device were effective in reducing aerosols, though the surgical smoke evacuation system was the most effective passive suction method in 2 of the 5 surgical conditions with statistical significance (P \.05). Conclusion. Significant aerosol concentrations were produced in the range of 0.30 to 10.0 mm during all rhinologic procedures in this cadaver simulation. Rhinologic surgery with a passive suction device results in significant mitigation of generated aerosols.