{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:22:19Z","timestamp":1790950939380,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:00:00Z","timestamp":1615334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Many routine sinonasal procedures utilising powered instruments are regarded as aerosol\u2010generating. This study aimed to assess how different instrument settings affect detectable droplet spread and patterns of aerosolised droplet spread during simulated sinonasal surgery in order to identify mitigation strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Simulation series using three\u2010dimensional (3\u2010D) printed sinonasal model. Fluorescein droplet spread was assessed following microdebriding and drilling of fluorescein\u2010soaked grapes and bones, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University dry lab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>3\u2010D printed sinonasal model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Patterns of aerosolised droplet spread.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and Conclusion<\/jats:title><jats:p>There were no observed fluorescein droplets or splatter in the measured surgical field after microdebridement of nasal polyps at aspecific irrigation rate and suction pressure. Activation of the microdebrider in the presence of excess fluid in the nasal cavity (reduced or blocked suction pressure, excessive irrigation fluid or bleeding) resulted in detectable droplet spread. Drilling with either coarse diamond or cutting burs resulted in detectable droplets and greater spread was observed when drilling within the anterior nasal cavity. High\u2010speed drilling is a high\u2010risk AGP but the addition of suction using a third hand technique reduces detectable droplet spread outside the nasal cavity. Using the instrument outside the nasal cavity inadvertently, or when unblocking, produces greater droplet spread and requires more caution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13743","type":"journal-article","created":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T08:27:41Z","timestamp":1613464061000},"page":"809-815","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Reducing the risks of endoscopic sinonasal surgery in the Covid\u201019 era"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7213-0387","authenticated-orcid":false,"given":"Samuel C.","family":"Leong","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Liverpool School of Tropical Medicine Liverpool UK"},{"name":"Liverpool Head and Neck Centre Aintree University Hospital Liverpool University Hospitals NHS Foundation Trust Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5434-1917","authenticated-orcid":false,"given":"Dilesh","family":"Mogre","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Wirral University Teaching Hospital NHS Foundation Trust Wirral UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elgan","family":"Davies","sequence":"additional","affiliation":[{"name":"Spire Regency Hospital Macclesfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-020-00424-7"},{"key":"e_1_2_11_3_1","unstructured":"Guidance for ENT during the COVID\u201019 pandemic. ENT UK. London U.K. https:\/\/www.entuk.org\/guidance\u2010ent\u2010during\u2010covid\u201019\u2010pandemic\u20100."},{"key":"e_1_2_11_4_1","unstructured":"Aerosol\u2010generating procedures in ENT. ENT UK. London U.K. https:\/\/www.entuk.org\/aerosol\u2010generating\u2010procedures\u2010ent."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22577"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820929274"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820951169"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1985.00800110054002"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2500\/105065894781874232"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556139607500109"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26239"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820949802"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29065"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22644"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13743","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.13743","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.13743","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T07:31:12Z","timestamp":1693294272000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.13743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,10]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1111\/coa.13743"],"URL":"https:\/\/doi.org\/10.1111\/coa.13743","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,10]]},"assertion":[{"value":"2020-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}