Study Design Cadaveric simulation study. Objective The novel coronavirus (COVID-19), which can be transmitted via aerosolized viral particles, has directed focus on protection of healthcare workers during procedures involving the upper aerodigestive tract, including maxillofacial trauma repair. This study evaluates particle generation at different distances from open reduction and internal fixation (ORIF) of maxillofacial injuries in the intraoperative setting to reduce the risk of contracting airborne diseases such as COVID-19. Methods Two cadaveric specimens in a simulated operating room underwent ORIF of midface and mandible fractures via intraoral incisions as well as maxillomandibular fixation (MMF) using hybrid arch bars. ORIF was performed with both self-drilling screws and with the use of a power drill for creating guide holes. Real-time aerosol concentration was measured throughout each procedure using 3 particle counters placed 0.45, 1.68, and 3.81 m (1.5, 5.5, and 12.5 feet, respectively) from the operative site. Results There was a significant decrease in particle concentration in all procedures at 1.68 m compared to 0.45 m, but only 2 of the 5 procedures showed further significant decrease in particle concentration when going from 1.68 to 3.81 m from the operative site. There was significantly less particle concentration generated at all distances when using self-drilling techniques compared to power drilling for ORIF. Conclusion Consideration of using self-drilling screwing techniques as well as maintaining physical distancing protocols may decrease risk of transmission of airborne diseases such as COVID-19 while in the intraoperative setting.

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Gentlemen,—In the following remarks I shall endeavour, as briefly as possible, to direct your attention to some important questions in connection with lunacy. For the purpose which I have in view it will be necessary to begin with some reference to statistics, but you will understand that such reference is of the baldest kind, and is not to be regarded as exhausting the light which it might throw upon the subjects discussed. Indeed, my statistics serve but as the rough pedestal on which to rest my arguments. It is highly probable that many whom I have the honour of addressing will differ from me in the views which I shall state, but I thought it well to take advantage of the opportunity which I owe to your kindness, to show you in what light matters with which most of you are familiar—so familiar, perhaps, that they may cease to excite your attention or stimulate you to reflection—appear from the stand-point of a Commissioner. But should you differ from me, I trust you will give me credit for having equally at heart with yourselves the welfare of the insane and the honour of the medical profession.