{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:11:16Z","timestamp":1787163076725,"version":"build-2736575974"},"reference-count":30,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec id=\"ab-ooi220067-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Despite growing scientific knowledge and research, it is still unknown if office flexible laryngoscopy (FL) is aerosol generating and thereby potentially increases the risk of SARS-CoV-2 transmission. The limited literature that exists is conflicting, precluding formal conclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220067-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether FL is aerosol generating.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220067-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This prospective cohort study included 134 patients seen in the otolaryngology clinic at a single tertiary care academic institution between February and May 2021. Two optical particle sizer instruments were used, quantifying particles ranging from 0.02 \u03bcm to 5 \u03bcm. Measurements were taken every 30 seconds, with sample periods of 15 seconds throughout the patient encounter. Instruments were located 12 inches from the patient\u2019s nares. Timing of events was recorded, including the start and end of physical examination, topical spray administration, start and end of laryngoscopy, and other potential aerosol-generating events (eg, coughing, sneezing). Data analysis was performed from February to May 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220067-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Office examination and office FL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220067-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Bayesian online change point detection (OCPD) algorithm was used to detect significant change points (CPs) in this time-series data. The primary outcome was significant CP after FL compared with baseline physiologic variations, such as breathing and phonation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220067-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data were collected from 134 patients between February and May 2021. Ninety-one encounters involved FL. Of this group, 51 patients (56%) wore no mask over their mouth during FL. There was no statistically significant CP in either visits involving FL or visits where FL was not performed. Use of nasal spray did not result in CP in aerosol levels. Overall, neither the number of people present in the examination room, masks over patients\u2019 mouth, the duration of the visit, nor the duration of FL were associated with mean aerosol counts, regardless of the exposure. For larger aerosol sizes (\u22651 \u03bcm), however, rooms with higher air exchange rates had significantly higher reductions in mean aerosol counts for visits involving FL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220067-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The findings of this cohort study support that FL, including topical spray administration, is not a significant aerosol-generating procedure. The Bayesian OCPD model has a promising application for future aerosol studies in otolaryngology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoto.2022.3316","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T11:12:26Z","timestamp":1666869146000},"page":"1140","source":"Crossref","is-referenced-by-count":2,"title":["Quantitative Evaluation of Aerosol Generation During In-Office Flexible Laryngoscopy"],"prefix":"10.1001","volume":"148","author":[{"given":"Amanda J.","family":"Bastien","sequence":"first","affiliation":[{"name":"Cedars-Sinai Medical Center, Los Angeles, California"},{"name":"Geisel School of Medicine at Dartmouth, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwame","family":"Wiredu","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth, Hanover, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew 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