Pearlman Ronald T, Sandidge Olisa
School of Communication, Department of Communication Sciences and Disorders, Howard University, Washington, DC 20059, USA.
Orthopedics. 2009 Nov;32(11):825. doi: 10.3928/01477447-20090922-09.
Several studies indicate that the noise generated by performing orthopedic surgery has the potential to cause hearing loss. Noise-induced hearing loss was found in 50% of the orthopedic surgeons studied using audiometric testing, with a greater incidence associated with years of practice. Noise produced by several orthopedic surgical instruments such as saws, drills, and hammers during surgery exceeds 100 dB, especially during knee replacement procedures. In one study, surgical space suits (personal protection systems) were suggested to help protect against noise-induced hearing loss, although space suit manufacturers do not market them as noise-reduction devices. A research protocol was developed to determine if commercially available surgical space suits help to reduce noise at the surgeon's ear. With the commercially available personal protection systems used in this research, there was no significant extra-helmet noise decrease by wearing the space suit. Sound inside the helmet at the level of the ear averaged 61 dBA, approximately the level of conversational speech, which may explain the difficulty the surgical staff may have hearing speech in the operating room when the space suit is worn with the fan on. If surgical noise is to be decreased, earplugs or muffs must be worn not only by the surgeon, but also by all personnel in the operating theater. At greatest risk may be the anesthesiologist, who may experience several orthopedic surgeries in a single day and is positioned close to the patient.
多项研究表明，进行骨科手术时产生的噪音有可能导致听力损失。通过听力测试发现，在接受研究的骨科外科医生中，有50%出现了噪音性听力损失，且随着从业年限的增加，发病率更高。在手术过程中，锯子、钻头和锤子等多种骨科手术器械产生的噪音超过100分贝，尤其是在膝关节置换手术期间。在一项研究中，有人建议使用手术太空服（个人防护系统）来帮助预防噪音性听力损失，尽管太空服制造商并未将其作为降噪设备进行销售。为此制定了一项研究方案，以确定市售的手术太空服是否有助于降低外科医生耳部的噪音。使用本研究中所采用的市售个人防护系统时，穿着太空服并没有使头盔外的噪音显著降低。耳部位置的头盔内声音平均为61分贝，大约是交谈时的音量，这或许可以解释当太空服风扇开启时，手术人员在手术室中可能难以听清交谈内容的原因。如果要降低手术噪音，不仅外科医生，手术室中的所有人员都必须佩戴耳塞或耳罩。风险最大的可能是麻醉医生，他们可能在一天内经历多台骨科手术，而且距离患者很近。
