{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:42:30Z","timestamp":1792806150180,"version":"4.5.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The authors developed a negative-pressure, patient face-mounted antechamber and tested its efficacy as a tool for sequestering aerated particles and improving the safety of endonasal surgical procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Antechamber prototyping was performed with 3D printing and silicone-elastomer molding. The lowest vacuum settings needed to meet specifications for class I biosafety cabinets (flow rate \u2265 0.38 m\/sec) were determined using an anemometer. A cross-validation approach with two different techniques, optical particle sizing and high-speed videography\/shadowgraphy, was used to identify the minimum pressures required to sequester aerosolized materials. At the minimum vacuum settings identified, physical parameters were quantified, including flow rate, antechamber pressure, and time to clearance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The minimum tube pressures needed to meet specifications for class I biosafety cabinets were \u22121.0 and \u221214.5 mm Hg for the surgical chambers with (\u201cclosed face\u201d) and without (\u201copen face\u201d) the silicone diaphragm covering the operative port, respectively. Optical particle sizing did not detect aerosol generation from surgical drilling at these vacuum settings; however, videography estimated higher thresholds required to contain aerosols, at \u22126 and \u221235 mm Hg. Simulation of surgical movement disrupted aerosol containment visualized by shadowgraphy in the open-faced but not the closed-faced version of the mask; however, the closed-face version of the mask required increased negative pressure (\u221215 mm Hg) to contain aerosols during surgical simulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Portable, negative-pressure surgical compartments can contain aerosols from surgical drilling with pressures attainable by standard hospital and clinic vacuums. Future studies are needed to carefully consider the reliability of different techniques for detecting aerosols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.10.jns202745","type":"journal-article","created":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T03:48:32Z","timestamp":1620964112000},"page":"1825-1832","source":"Crossref","is-referenced-by-count":3,"title":["Development and validation of a patient face-mounted, negative-pressure antechamber for reducing exposure of healthcare workers to aerosolized particles during endonasal surgery"],"prefix":"10.3171","volume":"135","author":[{"given":"Mark","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Weill Cornell Medicine, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel T.","family":"Rivera-Rosario","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Weill Cornell Medicine, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Bewley","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zellman","family":"Warhaft","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Stylman","sequence":"additional","affiliation":[{"name":"Environmental Health & Safety,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela I.","family":"Park","sequence":"additional","affiliation":[{"name":"Molecular Biology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aoife","family":"MacMahon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Weill Cornell Medicine, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh","family":"Kacker","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Weill Cornell Medicine, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Weill Cornell Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"r1","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e35797","DOI":"10.1371\/journal.pone.0035797","article-title":"Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review","volume":"7","author":"Tran K","year":"2012","unstructured":"Tran K, Cimon K, Severn M,  Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review. PLoS One. 2012;7(4):e35797.2256340310.1371\/journal.pone.0035797"},{"issue":"3","key":"r2","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1177\/0194599820931805","article-title":"Airborne aerosol generation during endonasal procedures in the era of COVID-19: risks and recommendations","volume":"163","author":"Workman AD","year":"2020","unstructured":"Workman AD, Jafari A, Welling DB,  Airborne aerosol generation during endonasal procedures in the era of COVID-19: risks and recommendations. Otolaryngol Head Neck Surg. 2020;163(3):465\u2013470.3245273910.1177\/0194599820931805"},{"issue":"9","key":"r3","series-title":"Int Forum Allergy Rhinol","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1002\/alr.22640","article-title":"Reply to: Endonasal drilling may be employed safely in the COVID-19 era","volume":"10","author":"Bleier BS","year":"2020","unstructured":"Bleier BS. Reply to: Endonasal drilling may be employed safely in the COVID-19 era. Int Forum Allergy Rhinol. 2020;10(9):1120.3250679310.1002\/alr.22640"},{"issue":"9","key":"r4","series-title":"Int Forum Allergy Rhinol","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1002\/alr.22642","article-title":"Endonasal drilling may be employed safely in the COVID-19 era","volume":"10","author":"Snyderman CH","year":"2020","unstructured":"Snyderman CH, Gardner PA. Endonasal drilling may be employed safely in the COVID-19 era. Int Forum Allergy Rhinol. 2020;10(9):1118\u20131119.10.1002\/alr.2264232515081"},{"issue":"12","key":"r5","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1056\/NEJMc2001737","article-title":"SARS-CoV-2 viral load in upper respiratory specimens of infected patients","volume":"382","author":"Zou L","year":"2020","unstructured":"Zou L, Ruan F, Huang M,  SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020;382(12):1177\u20131179.10.1056\/NEJMc200173732074444"},{"key":"r6","series-title":"BMJ","doi-asserted-by":"publisher","first-page":"m1435","DOI":"10.1136\/bmj.m1435","article-title":"Face masks for the public during the covid-19 crisis","volume":"369","author":"Greenhalgh T","year":"2020","unstructured":"Greenhalgh T, Schmid MB, Czypionka T,  Face masks for the public during the covid-19 crisis. BMJ. 2020;369:m1435.3227326710.1136\/bmj.m1435"},{"key":"r7","series-title":"Int J Infect Dis","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.ijid.2015.07.016","article-title":"Planning for the next global pandemic","volume":"38","author":"Ross AG","year":"2015","unstructured":"Ross AG, Crowe SM, Tyndall MW. Planning for the next global pandemic. Int J Infect Dis. 2015;38:89\u201394.2625346110.1016\/j.ijid.2015.07.016"},{"issue":"2","key":"r8","series-title":"Nat Rev Microbiol","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1038\/nrmicro.2017.174","article-title":"1918 influenza virus: 100 years on, are we prepared against the next influenza pandemic?","volume":"16","author":"Medina RA","year":"2018","unstructured":"Medina RA. 1918 influenza virus: 100 years on, are we prepared against the next influenza pandemic? Nat Rev Microbiol. 2018;16(2):61\u201362.10.1038\/nrmicro.2017.17429332942"},{"issue":"10127","key":"r9","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1016\/S0140-6736(17)33293-2","article-title":"Estimates of global seasonal influenza-associated respiratory mortality: a modelling study","volume":"391","author":"Iuliano AD","year":"2018","unstructured":"Iuliano AD, Roguski KM, Chang HH,  Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet. 2018;391(10127):1285\u20131300.10.1016\/S0140-6736(17)33293-229248255"},{"issue":"5","key":"r10","series-title":"Cureus","first-page":"e8126","article-title":"The Vacuum Assisted Negative Pressure Isolation Hood (VANISH) system: novel application of the Stryker Neptune\u2122 suction machine to create COVID-19 negative pressure isolation environments","volume":"12","author":"Convissar D","year":"2020","unstructured":"Convissar D, Chang CY, Choi WE,  The Vacuum Assisted Negative Pressure Isolation Hood (VANISH) system: novel application of the Stryker Neptune\u2122 suction machine to create COVID-19 negative pressure isolation environments. Cureus. 2020;12(5):e8126.32426202"},{"issue":"2","key":"r11","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1097\/ALN.0000000000003369","article-title":"Protective device during airway management in patients with coronavirus disease (COVID19)","volume":"133","author":"Rahmoune FC","year":"2020","unstructured":"Rahmoune FC, Ben Yahia MM, Hajjej R,  Protective device during airway management in patients with coronavirus disease (COVID19). Anesthesiology. 2020;133(2):473\u2013475.10.1097\/ALN.000000000000336932358250"},{"issue":"7","key":"r12","series-title":"Can J Anaesth","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1007\/s12630-020-01649-w","article-title":"Clear plastic drapes may be effective at limiting aerosolization and droplet spray during extubation: implications for COVID-19","volume":"67","author":"Matava CT","year":"2020","unstructured":"Matava CT, Yu J, Denning S. Clear plastic drapes may be effective at limiting aerosolization and droplet spray during extubation: implications for COVID-19. Can J Anaesth. 2020;67(7):902\u2013904.10.1007\/s12630-020-01649-w32246431"},{"issue":"3","key":"r13","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1177\/0194599820931836","article-title":"Endoscopic skull base surgery protocol from the frontlines: transnasal surgery during the COVID-19 pandemic","volume":"163","author":"Spock T","year":"2020","unstructured":"Spock T, Kessler R, Lerner D,  Endoscopic skull base surgery protocol from the frontlines: transnasal surgery during the COVID-19 pandemic. Otolaryngol Head Neck Surg. 2020;163(3):482\u2013490.10.1177\/019459982093183632452722"},{"issue":"3","key":"r14","series-title":"Oper Neurosurg (Hagerstown)","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1093\/ons\/opaa168","article-title":"Ventilated upper airway endoscopic endonasal procedure mask: surgical safety in the COVID-19 era","volume":"19","author":"Helman SN","year":"2020","unstructured":"Helman SN, Soriano RM, Tomov ML,  Ventilated upper airway endoscopic endonasal procedure mask: surgical safety in the COVID-19 era. Oper Neurosurg (Hagerstown). 2020;19(3):271\u2013280.10.1093\/ons\/opaa168"},{"key":"r15","series-title":"Human Factors Design Standard (DOT\/FAA\/HF- STD-001B)","author":"Ahlstrom V","year":"2016","unstructured":"Ahlstrom V. Human Factors Design Standard (DOT\/FAA\/HF- STD-001B). Federal Aviation Administration William J. Hughes Technical Center; 2016. Accessed December 8, 2020. https:\/\/hf.tc.faa.gov\/publications\/2016-12-human-factors-design-standard\/"},{"issue":"11","key":"r16","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"2637","DOI":"10.1002\/lary.28973","article-title":"Is office laryngoscopy an aerosol-generating procedure?","volume":"130","author":"Rameau A","year":"2020","unstructured":"Rameau A, Lee M, Enver N, Sulica L. Is office laryngoscopy an aerosol-generating procedure? Laryngoscope. 2020;130(11):2637\u20132642.3267184010.1002\/lary.28973"},{"key":"r17","series-title":"Primary Containment for Biohazards: Selection, Installation and Use of Biological Safety Cabinets","author":"Richmond J","year":"2000","unstructured":"Richmond J, McKinney R. Primary Containment for Biohazards: Selection, Installation and Use of Biological Safety Cabinets. US Department of Health and Human Services; 2000. Accessed December 8, 2020. https:\/\/www.hsdl.org\/?abstract&did=1878"},{"key":"r18","series-title":"Guidelines for Environmental Infection Control in Health-Care Facilities: Recommendations of CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC)","author":"Chinn RY","year":"2003","unstructured":"Chinn RY, Sehulster L. Guidelines for Environmental Infection Control in Health-Care Facilities: Recommendations of CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC). Centers for Disease Control and Prevention; 2003. Accessed December 8, 2020. https:\/\/www.cdc.gov\/infectioncontrol\/pdf\/guidelines\/environmental-guidelines-P.pdf"},{"issue":"3","key":"r19","series-title":"Pathogens","doi-asserted-by":"publisher","first-page":"231","DOI":"10.3390\/pathogens9030231","article-title":"SARS-CoV-2 and coronavirus disease 2019: what we know so far","volume":"9","author":"Rabi FA","year":"2020","unstructured":"Rabi FA, Al Zoubi MS, Kasasbeh GA,  SARS-CoV-2 and coronavirus disease 2019: what we know so far. Pathogens. 2020;9(3):231.10.3390\/pathogens9030231"},{"issue":"1","key":"r20","series-title":"BMC Infect Dis","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s12879-019-3707-y","article-title":"Recognition of aerosol transmission of infectious agents: a commentary","volume":"19","author":"Tellier R","year":"2019","unstructured":"Tellier R, Li Y, Cowling BJ, Tang JW. Recognition of aerosol transmission of infectious agents: a commentary. BMC Infect Dis. 2019;19(1):101.3070440610.1186\/s12879-019-3707-y"},{"issue":"2","key":"r21","series-title":"Indoor Air","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1111\/ina.12314","article-title":"Short-range airborne transmission of expiratory droplets between two people","volume":"27","author":"Liu L","year":"2017","unstructured":"Liu L, Li Y, Nielsen PV,  Short-range airborne transmission of expiratory droplets between two people. Indoor Air. 2017;27(2):452\u2013462.2728759810.1111\/ina.12314"},{"issue":"9)(suppl)","key":"r22","series-title":"Am J Infect Control","doi-asserted-by":"publisher","first-page":"S102","DOI":"10.1016\/j.ajic.2016.06.003","article-title":"Airborne spread of infectious agents in the indoor environment","volume":"44","author":"Wei J","year":"2016","unstructured":"Wei J, Li Y. Airborne spread of infectious agents in the indoor environment. Am J Infect Control. 2016;44(9)(suppl):S102\u2013S108.10.1016\/j.ajic.2016.06.00327590694"},{"issue":"17","key":"r23","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1710","DOI":"10.1056\/NEJMp048051","article-title":"Airborne transmission of communicable infection\u2014the elusive pathway","volume":"350","author":"Roy CJ","year":"2004","unstructured":"Roy CJ, Milton DK. Airborne transmission of communicable infection\u2014the elusive pathway. N Engl J Med. 2004;350(17):1710\u20131712.10.1056\/NEJMp04805115102996"},{"issue":"16","key":"r24","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1564","DOI":"10.1056\/NEJMc2004973","article-title":"Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1","volume":"382","author":"van Doremalen N","year":"2020","unstructured":"van Doremalen N, Bushmaker T, Morris DH,  Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564\u20131567.3218240910.1056\/NEJMc2004973"},{"issue":"21","key":"r25","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"2063","DOI":"10.1056\/NEJMc2009324","article-title":"Droplets and aerosols in the transmission of SARS-CoV-2","volume":"382","author":"Meselson M","year":"2020","unstructured":"Meselson M. Droplets and aerosols in the transmission of SARS-CoV-2. N Engl J Med. 2020;382(21):2063.10.1056\/NEJMc200932432294374"},{"issue":"3","key":"r26","series-title":"J Infect Dis","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1093\/infdis\/153.3.634","article-title":"Efficacy of infection control measures during a nosocomial outbreak of disseminated aspergillosis associated with hospital construction","volume":"153","author":"Opal SM","year":"1986","unstructured":"Opal SM, Asp AA, Cannady PB Jr,  Efficacy of infection control measures during a nosocomial outbreak of disseminated aspergillosis associated with hospital construction. J Infect Dis. 1986;153(3):634\u2013637.293683010.1093\/infdis\/153.3.634"},{"issue":"2","key":"r27","series-title":"Clin Med (Lond)","doi-asserted-by":"publisher","first-page":"124","DOI":"10.7861\/clinmed.2019-coron","article-title":"What we know so far: COVID-19 current clinical knowledge and research","volume":"20","author":"Lake MA","year":"2020","unstructured":"Lake MA. What we know so far: COVID-19 current clinical knowledge and research. Clin Med (Lond). 2020;20(2):124\u2013127.10.7861\/clinmed.2019-coron"},{"key":"r28","series-title":"Experimental Measurements of Human Cough Airflows from Healthy Subjects and Those Infected With Respiratory Viruses [dissertation]","author":"Dudalski N","year":"2018","unstructured":"Dudalski N. Experimental Measurements of Human Cough Airflows from Healthy Subjects and Those Infected With Respiratory Viruses [dissertation]. London, ON: University of Western Ontario; 2018."},{"issue":"2","key":"r29","series-title":"J Aerosol Sci","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.jaerosci.2008.10.003","article-title":"Characterization of expiration air jets and droplet size distributions immediately at the mouth opening","volume":"40","author":"Chao CYH","year":"2009","unstructured":"Chao CYH, Wan MP, Morawska L,  Characterization of expiration air jets and droplet size distributions immediately at the mouth opening. J Aerosol Sci. 2009;40(2):122\u2013133.10.1016\/j.jaerosci.2008.10.00332287373"},{"issue":"1","key":"r30","series-title":"BMC Pulm Med","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1471-2466-12-11","article-title":"Cough aerosol in healthy participants: fundamental knowledge to optimize droplet-spread infectious respiratory disease management","volume":"12","author":"Zayas G","year":"2012","unstructured":"Zayas G, Chiang MC, Wong E,  Cough aerosol in healthy participants: fundamental knowledge to optimize droplet-spread infectious respiratory disease management. BMC Pulm Med. 2012;12(1):11.2243620210.1186\/1471-2466-12-11"},{"issue":"3","key":"r31","series-title":"J Occup Environ Hyg","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1080\/15459620590918466","article-title":"Toward understanding the risk of secondary airborne infection: emission of respirable pathogens","volume":"2","author":"Nicas M","year":"2005","unstructured":"Nicas M, Nazaroff WW, Hubbard A. Toward understanding the risk of secondary airborne infection: emission of respirable pathogens. J Occup Environ Hyg. 2005;2(3):143\u2013154.1576453810.1080\/15459620590918466"},{"issue":"6","key":"r32","series-title":"J Hyg (Lond)","first-page":"471","article-title":"The size and the duration of air-carriage of respiratory droplets and droplet-nuclei","volume":"44","author":"Duguid JP","year":"1946","unstructured":"Duguid JP. The size and the duration of air-carriage of respiratory droplets and droplet-nuclei. J Hyg (Lond). 1946;44(6):471\u2013479."},{"issue":"5071","key":"r33","series-title":"Nature","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1038\/213095a0","article-title":"Relation between the airborne diameters of respiratory droplets and the diameter of the stains left after recovery","volume":"213","author":"Loudon RG","year":"1967","unstructured":"Loudon RG, Roberts RM. Relation between the airborne diameters of respiratory droplets and the diameter of the stains left after recovery. Nature. 1967;213(5071):95\u201396.10.1038\/213095a0"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/135\/6\/article-p1825.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/135\/6\/article-p1825.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/135\/6\/article-p1825.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:52:08Z","timestamp":1792803128000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/135\/6\/article-p1825.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":33,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2020.10.jns202745","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]}}}