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

TL;DR

This study shows that a new surgical drape called Otodome significantly reduces droplet spread during mastoidectomy procedures.

Contribution

The novel Otodome barrier drape effectively limits droplet dispersion during mastoid drilling compared to traditional methods.

Findings

Droplets spread up to 290cm without a drape but only 78cm with Otodome.

The Otodome confined heavy contamination within the surgical field.

The surgeon's face and head were not contaminated when using Otodome.

Abstract

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.

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