Droplet Generation During Mastoidectomy and Mitigation by Use of a Novel Barrier Drape.

OBJECTIVE

This study aims to investigate the degree of contamination generated by mastoid drilling and the extent to which this is mitigated by the use of a novel barrier drape, Otodome, which contains the surgical field.

STUDY

DESIGN

Cortical mastoidectomy with a high-speed self-irrigating drill was performed under three test conditions in the cadaveric lab, including A, without a microscope, B, with a microscope alone and C, with a microscope fitted with the Otodome. Schülke Optics fluorescent solution was used as irrigation fluid.

SETTING

High-speed irrigation drills used during mastoidectomy create large amounts of droplet dispersion. This study quantifies the amount of droplet dispersion and the extent to which the barrier drape mitigates it.

METHODS

The degree (mild, moderate or severe), distribution, and distance of contamination of the surroundings were collected in each test condition. The extent of contamination of the surgeon was noted.

RESULTS

Condition A had the worst contamination of both the surgeon and surroundings, with the furthest distance and heaviest density of droplet spread after a cortical mastoidectomy. Droplets were dispersed up to 290cm from the surgical field. Using the barrier drape in Condition C significantly reduced the droplet dispersion to a maximum of 78cm from the surgical field. There was a significant reduction in the density of contamination of the surroundings. Most of the heavy contamination was confined within the barrier drape. There was no contamination of the surgeon's face and head region.

CONCLUSION

Mastoid drilling produces an extensive amount of droplet dispersion. Improvised barrier drapes have been shown to mitigate this problem, but are cumbersome to use. The Otodome is shown to be an effective barrier drape.