Particle aerosolization with energy devices: A comparative study

Abstract

Abstract Objective To compare the degree of particle aerosolization with the use of several energy devices used in tonsillectomy and other common upper airway procedures. Methods Three different energy devices were measured. These included (a) monopolar electrocautery, (b) bipolar electrocautery, and (c) thermal welding device (TWD). Each device was applied to fresh cadaveric cow tongue and porcine nose. Aerosolized particles produced by these devices were measured using a calibrated electronic particle counter. Measurements were recorded over the course of 3 minutes. Particle sizes were measured at 0.3, 0.5, 1.0, 5, and 10 μm. Results In comparing types of tissues and particle sizes, TWD had the lowest aerosolizing burden among the three devices. By analyzing the highest particle value of TWD against both monopolar and bipolar, monopolar electrocautery proved to have the highest aerosolization exposure with statistical significance at 0.5 and 10 μm. No statistical significance was found when comparing TWD against monopolar electrocautery. Discussion Our study demonstrates there is a difference in aerosolization burden dependent on the type of device utilized. TWD proved to have the lowest burden whereas monopolar electrocautery had the highest. Conclusion TWD produces less aerosolization than conventional monopolar electrocautery when cauterizing or ablating tissue in an experimental setting. The degree of aerosolization was comparable to bipolar electrocautery. Level of Evidence 2.

Keywords

• bipolar electrocautery
• ENTceps
• monopolar electrocautery
• SARS‐CoV‐2
• thermal welding device
• tonsillectomy