Affiliation:
1. Division of Otolaryngology–Head and Neck Surgery The George Washington University School of Medicine and Health Sciences Washington District of Columbia USA
2. Department of Otolaryngology Children's National Hospital Washington District of Columbia USA
3. Division of Surgery Children's National Hospital Washington District of Columbia USA
Abstract
AbstractObjectiveOperating room (OR) sounds may surpass noise exposure thresholds and induce hearing loss. Noise intensity emitted by various surgical instruments during common pediatric otolaryngologic procedures were compared at the ear‐level of the surgeon and patient to evaluate the need for quality improvement measures.Study DesignCross‐sectional study.SettingSingle tertiary care center.MethodsNoise levels were measured using the RISEPRO Sound Level Meter and SoundMeter X 10.0.4 at the ear level of surgeon and patient every 5 minutes. Operative procedure and instrument type were recorded. Measured noise levels were compared against ambient noise levels and the Apple Watch Noise application.ResultsTwo hundred forty‐two total occasions of noise were recorded across 62 surgical cases. Cochlear implantation surgery produces the loudest case at the ear‐level of the patient (91.8 Lq Peak dB; P < .001). The otologic drill was the loudest instrument for the patient (92.1 Lq Peak dB; P < .001), while the powered microdebrider was the loudest instrument for the surgeon (90.7 Lq Peak dB; P = .036). Noise measurements between surgeon and patient were similar (P < .05). Overall agreement between the Noise application and Sound Level Meter was excellent (intraclass correlation coefficient of 0.8, with a 95% confidence interval ranging from 0.32 to 0.92).ConclusionOtolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise‐related hearing loss. Mitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long‐term hearing conservation.DiscussionOtolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise‐related hearing loss. The duration, frequency of exposure, and volume levels of noise should be studied further.Implications for PracticeMitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long‐term hearing conservation.