{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:59:23Z","timestamp":1783774763766,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2020,7]]},"abstract":"Objectives<\/jats:title>This study aimed to identify escape of small\u2010particle aerosols from a variety of masks using simulated breathing conditions. This study also aimed to evaluate the efficacy of a negative\u2010pressure environment around the face in preventing the escape of small aerosolized particles.<\/jats:p><\/jats:sec>Study Design<\/jats:title>This study is an evaluation study with specific methodology described below.<\/jats:p><\/jats:sec>Setting<\/jats:title>This study was performed in our institution\u2019s fresh tissue laboratory.<\/jats:p><\/jats:sec>Subjects and Methods<\/jats:title>A fixed cadaver head was placed in a controlled environment with a black background, and small\u2010particle aerosols were created using joss incense sticks (mass\u2010median aerosol diameter of 0.28 \u00b5). Smoke was passed through the cadaver head, and images were taken with a high\u2010resolution camera in a standardized manner. Digital image processing was used to calculate relative amounts of small\u2010particle escape from a variety of masks, including a standard surgical mask, a modified Ambu mask, and our negative airway pressure respirator (NAPR).<\/jats:p><\/jats:sec>Results<\/jats:title>Significant amounts of aerosolized particles escaped during the trials with no mask, a standard surgical mask, and the NAPR without suction. When suction was applied to the NAPR, creating a negative\u2010pressure system, no particle escape was noted.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>We present a new and effective method for the study of small\u2010particle aerosols as a step toward better understanding the spread of these particles and the transmission of coronavirus disease 2019. We also present the concept of an NAPR to better protect health care workers from aerosols generated from the upper and lower airways.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820929275","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T04:02:26Z","timestamp":1589860946000},"page":"151-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Aerosolized Particle Reduction: A Novel Cadaveric Model and a Negative Airway Pressure Respirator (NAPR) System to Protect Health Care Workers From COVID\u201019"],"prefix":"10.1002","volume":"163","author":[{"given":"Tawfiq","family":"Khoury","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania 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Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,19]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"The Coronavirus and the Great Influenza Pandemic: Lessons From the \u201cSpanish Flu\u201d for the Coronavirus\u2019s Potential Effects on Mortality and Economic Activity","author":"Barro 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