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Aerosolisation in endonasal endoscopic pituitary surgery.

Authors
  • Dhillon, Rana S1
  • Nguyen, Lana V2
  • Rowin, Wagih Abu3
  • Humphries, Ruhi S4
  • Kevin, Kevin3
  • Ward, Jason D4
  • Yule, Andrew5
  • Phan, Tuong D6, 7
  • Zhao, Yi Chen8
  • Wynne, David2
  • McNeill, Peter M2
  • Hutchins, Nicholas3
  • Scott, David A6, 7
  • 1 Department of Neurosurgery, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia. [email protected] , (Australia)
  • 2 Department of Neurosurgery, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia. , (Australia)
  • 3 Department of Mechanical Engineering, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia. , (Australia)
  • 4 Climate Science Centre, CSIRO Oceans and Atmosphere, 107 Station Street, Aspendale, VIC, 3195, Australia. , (Australia)
  • 5 ARPANSA (Australian Radiation Protection and Nuclear Safety Agency), 619 Lower Plenty Road, Yallambie, VIC, 3085, Australia. , (Australia)
  • 6 Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia. , (Australia)
  • 7 University of Melbourne, Parkville, Australia. , (Australia)
  • 8 Department of Ear, Nose and Throat Surgery, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia. , (Australia)
Type
Published Article
Journal
Pituitary
Publisher
Springer-Verlag
Publication Date
Aug 01, 2021
Volume
24
Issue
4
Pages
499–506
Identifiers
DOI: 10.1007/s11102-021-01125-8
PMID: 33469830
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To determine the particle size, concentration, airborne duration and spread during endoscopic endonasal pituitary surgery in actual patients in a theatre setting. This observational study recruited a convenience sample of three patients. Procedures were performed in a positive pressure operating room. Particle image velocimetry and spectrometry with air sampling were used for aerosol detection. Intubation and extubation generated small particles (< 5 µm) in mean concentrations 12 times greater than background noise (p < 0.001). The mean particle concentrations during endonasal access were 4.5 times greater than background (p = 0.01). Particles were typically large (> 75 µm), remained airborne for up to 10 s and travelled up to 1.1 m. Use of a microdebrider generated mean aerosol concentrations 18 times above baseline (p = 0.005). High-speed drilling did not produce aerosols greater than baseline. Pituitary tumour resection generated mean aerosol concentrations less than background (p = 0.18). Surgical drape removal generated small and large particles in mean concentrations 6.4 times greater than background (p < 0.001). Intubation and extubation generate large amounts of small particles that remain suspended in air for long durations and disperse through theatre. Endonasal access and pituitary tumour resection generate smaller concentrations of larger particles which are airborne for shorter periods and travel shorter distances. © 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.

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