Experimental determination of the influence of different droplet protection covers on the workflow of a mastoidectomy

Introduction Potentially infectious aerosols and droplets are released during mastoidectomy. Protection against this is provided by a tent-like enclosure (EH) attached to the surgical microscope. However, the impact of such protective mechanisms in terms of operator impairment is unclear, so it was our aim to evaluate this using a standardized experimental setup.

Material and methods 3 test situations were defined: T1 without EH, T2 with partial EH (arms of the surgeon under the EH, EH must be opened when changing instruments), and T3 with complete EH (arms of the surgical assistant, arms of the surgeon, and frequently used instruments under the EH). Standardized activities (injection and aspiration of 10 ml of fluid from 4 vessels each) were studied and performed by 7 subjects. This was followed by an evaluation of the activities using the NASA Task Load Index (TLX), where the subjectively perceived workload is rated from 0 to a maximum of 21.

Results At T1 the mean TLX was 4.0, at T2 5.26 and at T3 4.14. Significant increases were observed in the subgroups "effort" (p=0.006) and "frustration" (p=0.010) in comparison between T1 and T2. Between T1 and T3, "physical demand" showed a significant increase (p=0.023) in complete enclosure. This increase was also seen between T1 and T2, but it was just not significant at p=0.054. Between T3 and T2, there was a significantly higher "frustration" (p=0.017) of the subjects.

Conclusion A benefit of full enclosure compared to partial enclosure in terms of TLX was demonstrated. The use of an enclosure is feasible without relevant restrictions for the surgeon.

Publication History

Article published online:
12 May 2023