Quantification and visualization of aerosols in ear, nose, and throat exam and flexible laryngoscopy

OBJECTIVE: To measure and visualize aerosol generation during ear, nose, and throat (ENT) exam and flexible laryngoscopy, as safety recommendations are currently to defer routine and low‐priority examinations. METHODS: Aerosols generated during ENT examination and flexible laryngoscopy were quantified by laser aerosol spectrometry and visualized live by high‐speed imaging during those procedures for three participants who were tested three times for each test. RESULTS: Routine ENT examination and flexible laryngoscopy produce aerosols at levels comparable to normal breathing and speech. CONCLUSION: During ENT examination and flexible laryngoscopy, the practitioner should wear a surgical mask and potentially contaminated surfaces should be cleaned after the procedure. For flexible laryngoscopy, it is recommended in addition that the patient wear a mask over the mouth in case the procedure induces a sneeze. The time during which the patient is unmasked should be minimized. In these settings, the risk to the practitioner is minimal unless the patient is sneezing or symptomatic. LEVEL OF EVIDENCE: 1