COVID-19 in the Clinic: Human Testing of an Aerosol Containment Mask for Endoscopic Clinic Procedures

COVID-19 in the Clinic: Trial of an Aerosol Containment Mask for Endoscopic Clinic Procedures

OBJECTIVE

Create an aerosol containment mask (ACM) for common otolaryngologic endoscopic procedures which also provides nanoparticle-level protection to patients.

STUDY DESIGN

Prospective feasibility study.

SETTING

In-person testing with a novel ACM.

METHODS

The mask was designed in Solidworks and 3-dimensional printed. Measurements were made on 100 consecutive clinic patients who underwent medically necessarily endoscopy, 50 rigid nasal and 50 flexible, by 9 surgeons.

RESULTS

Of the 50 patients who underwent rigid nasal endoscopy with the ACM, 0 of 25 patients with the suction off and 0 of 25 patients with the suction on had evidence of leakage of 0.3 μm particles. Of the 50 patients who underwent flexible endoscopy with the ACM, 0 of 25 patients with the suction off and 0 of 25 patients with the suction on had evidence of leakage of 0.3 μm particles. In terms of comfort, 73% of patients found the ACM somewhat or very comfortable without suction, compared to 86% with the suction on. Surgeons were able to visualize all necessary anatomic areas in 98% of procedures. In 97% of procedures, the masks were able to be placed easily.

CONCLUSION

ACM can accommodate rigid nasal and flexible endoscopes and may prevent leakage of patient-generated aerosols, thus avoiding contamination of the room and protecting health care workers from airborne contagions.

LEVEL OF EVIDENCE

The level of evidence is 2.

Innovative dual-function protective scope mask and filtration system for aerosol generating ENT scope procedures

Background

Aerosol-generating procedures (AGPs), such as nasoendoscopy, are considered high-risk during the COVID-19 pandemic due to risk of virus aerosol transmission. We aim to evaluate the efficacy of an innovative system in reduction of aerosol contamination.

Methods

Pilot study involving 15 healthy volunteers performing aerosol-generating activities with the prototype, compared with and without a standard surgical mask.

Results

We found an increased frequency of smaller-sized particle emissions for all four expiratory activities. The particle emission rate with the prototype mask was significantly slower over time for the smallest sized particle (0.3 μm) during breathing, speaking and singing compared with similar activities without the mask (p < .05). We found similar trends for coughing for larger particles but that did not reach statistical significance.

Conclusion

The innovation offers good protection against aerosol transmission through the physical barrier of the mask, the negative pressure environment within the mask, and the unit's dual filtration function.

Level of evidence

Level 2b.