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Pediatric Otolaryngology

Risk of Noise-Induced Hearing Loss in Pediatric ENT Operating Rooms

Tuesday, October 3, 2023
9:57 AM - 10:03 AM East Coast USA Time
Location: 207CD

    Presenting Author(s)

  • Leyn B. Shakhtour, BS

    Medical Student
    George Washington University School of Medicine and Health Sciences
    Washington, District of Columbia, United States

    • Co-Author(s)

  • Leyn B. Shakhtour, BS

    Medical Student
    George Washington University School of Medicine and Health Sciences
    Washington, District of Columbia, United States

  • NO

    Nicklas C. Orobello, MD

    Pediatric otolaryngologist
    Department of Otolaryngology, Children's National Hospital
    Tampa, FL, United States

  • Chloe B. Harrington, MD

    Resident physician
    Department of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences
    Washington, DC, United States

  • HB

    Hengameh K. Behzadpour, MSHS

    Clinical Research Coordinator
    Children's National Medical Center
    Washington, District of Columbia, United States

    • Senior Author(s)

  • Brian K. Reilly, MD

    Member
    Childrens National Medical Center
    Washington, DC, United States

Disclosure(s):
Leyn B. Shakhtour, BS: No relevant relationships to disclose.
Introduction: Operating room (OR) sound may surpass noise exposure thresholds and induce hearing loss in both patients and surgeons alike. The intensity of noises 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.

Methods: Noise levels were measured using the RISEPRO Decibel Meter and the SoundMeter X application 10.0.4 at the ear-level of the surgeon and patient every five minutes. For each measurement, operative procedure type, presence of music, and the type of instrument (suction bovie, microdebrider, COBLATOR, otologic drill) were recorded. All noise measurements were statistically compared against control measurements (background noise). Additional noise measurements will be measured with the Apple Watch Series 8 and analyzed for improving surgeon’s situational awareness of harmful noise levels.

Results: 242 total occasions of noise measurements were recorded for 62 cases from seven different surgeons. Cochlear implantation was found to be the loudest case for both surgeon (88.5 Lq Peak dBA; p=0.001) and patient (91.8 Lq Peak dBA; p< 0.001). Tympanomastoidectomy was the second loudest, with the surgeon’s noise exposure 87.6 Leq Peak dBA (p=0.001) and patient’s noise exposure 84.8 Leq Peak dBA (p < 0.001). The loudest instrument at the ear-level of the surgeon (89.4 Lq Peak dBA; p< 0.001) and patient (92.1 Lq Peak dBA; p< 0.001) was the otologic drill.

Conclusions: Pediatric ENT OR noises can surpass safe thresholds and may induce hearing loss in providers. Fortunately, these operations are short in duration so there is probably no long-term harm to the patient. However, chronic loud noise exposure to healthcare providers needs to be further addressed. Quality improvement measures, such as confirming the presence of a sound level meter in the OR, will increase OR noise awareness and promote mitigation strategies to maximize hearing conservation and long-term hearing preservation in surgeons.