Verhaert N, Moyaert N, Godderis L, Debruyne F, Desloovere C, Luts H
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
B-ENT. 2013;9(1):3-8.
To monitor the noise exposure of care providers during otological surgery due to drilling and suction in the operating room.
A clinical study monitoring different standard otosurgical procedures was conducted; cochlear implantation (CI), mastotympanoplasty, and mastoidectomy alone. Noise exposure to the surgeon and assistant were monitored with wireless personal noise dosimetry and stationary sound monitoring. Both maximum peak level in dBC (Lpeak) and time-average sound pressure level in dBA (equivalent level or Leq) were measured during drilling episodes. Frequency analysis in one third octaves covering the frequency bands 6.3 Hz to 20 k Hz was performed using a sound analyzing program.
When averaged over the entire procedure, the sound pressure level was highest for the surgeon and the assistant with values of 76.0 dBA and 72.5 dBA, respectively, during CI. Lpeak was 135.9 dBC. Leq for the stationary sound measurement was 74.2 dBA. During cortical bone work using a cutting burr, 84.6 dBA was measured. Mean values of L95% (estimation of the background noise) were between 55.8 dBA and 61.2 dBA. Frequency analysis showed the highest sound pressure level for all procedures was between 2.5 kHz and 3.15 kHz.
This is the first study to use personal sound dosimetry to monitor noise exposure during otosurgical drilling. In accordance with other studies, the results presented show sound levels below international occupational noise level regulations. However, the measured noise exposure during drilling could have negative effects on care providers based on unfavorable acoustical comfort.
监测手术室中进行耳科手术时,由于钻孔和吸引操作而导致医护人员的噪声暴露情况。
开展一项临床研究,监测不同的标准耳科手术程序;单独进行人工耳蜗植入术(CI)、乳突鼓室成形术和乳突切除术。使用无线个人噪声剂量计和固定声音监测设备,对外科医生和助手的噪声暴露情况进行监测。在钻孔过程中,测量dBC中的最大峰值水平(Lpeak)和dBA中的时间平均声压级(等效水平或Leq)。使用声音分析程序,对覆盖6.3 Hz至20 kHz频段的1/3倍频程进行频率分析。
在整个手术过程中进行平均时,人工耳蜗植入术期间外科医生和助手的声压级最高,分别为76.0 dBA和72.5 dBA。Lpeak为135.9 dBC。固定声音测量的Leq为74.2 dBA。在使用切割钻进行皮质骨操作时,测量值为84.6 dBA。L95%(背景噪声估计值)的平均值在55.8 dBA至61.2 dBA之间。频率分析表明,所有手术程序中最高声压级在2.5 kHz至3.15 kHz之间。
这是第一项使用个人声音剂量计监测耳科手术钻孔过程中噪声暴露的研究。与其他研究一致,所呈现的结果表明声级低于国际职业噪声水平规定。然而,基于不利的声学舒适度,钻孔过程中测得的噪声暴露可能会对医护人员产生负面影响。