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玻璃体切割手术中手术团队听力损失的风险。

Risk for Surgical Team Hearing Loss With Vitrectomy.

作者信息

Ruparelia Sunil, Orr Samantha, Choudhry Netan, Wong Robert W, Smith Corey A, Taylor S Mark, Gupta R Rishi

机构信息

Dalhousie Medical School, Halifax, NS, Canada.

Vitreous Retina Macula Specialists of Toronto, Etobicoke, ON, Canada.

出版信息

J Vitreoretin Dis. 2023 May 17;7(5):397-403. doi: 10.1177/24741264231172564. eCollection 2023 Sep-Oct.

Abstract

To assess sound-level exposure during vitrectomy using 3 of the most common commercially available machines. This noninterventional cross-sectional study examined sound emission from the Constellation, Stellaris, and EVA vitrector systems. For each machine, a noise dosimeter was used to measure the sound-level exposure of the surgeon during 3 surgical cases in which vitrectomy was performed. Sound levels associated with progressively increasing cut rates and vacuum pressures were also measured. Finally, sound measurements were taken during the use of various additional functions of each machine, including diathermy, laser, and extrusion. Sound levels were compared with occupational health guidelines in Canada and the United States. The maximum sound level recorded during vitrectomy surgery was 88.2 dBA. The mean sound level during vitrectomy surgical cases ranged from 58.5 to 66.8 dBA. A strong positive linear correlation was found between the cut rate and sound level ( = 0.88-0.98) and the vacuum pressure and sound level ( = 0.83-0.97). This relationship was consistent across the 3 vitrector systems ( < .001). Noise exposure during vitrectomy procedures was acceptable but may be sufficient for surgical team activity interference, as described by World Health Organization recommendations. A strong correlation was found between the cut rate and noise exposure. If cut rates continue to increase, attention should be given to ensure that the resulting noise exposure does not threaten the hearing of vitreoretinal surgeons and the operating room staff.

摘要

使用3种最常见的商用机器评估玻璃体切割术中的声级暴露情况。这项非干预性横断面研究检测了Constellation、Stellaris和EVA玻璃体切割系统的声音排放。对于每台机器,使用噪声剂量计测量外科医生在3例进行玻璃体切割术的手术过程中的声级暴露情况。还测量了与切割速率和真空压力逐渐增加相关的声级。最后,在使用每台机器的各种附加功能(包括透热疗法、激光和挤压)期间进行了声音测量。将声级与加拿大和美国的职业健康指南进行了比较。玻璃体切割术期间记录的最高声级为88.2 dBA。玻璃体切割术手术过程中的平均声级范围为58.5至66.8 dBA。发现切割速率和声级之间(=0.88 - 0.98)以及真空压力和声级之间(=0.83 - 0.97)存在强正线性相关性。这种关系在3种玻璃体切割系统中是一致的(<0.001)。玻璃体切割术过程中的噪声暴露是可接受的,但可能足以干扰手术团队的活动,如世界卫生组织的建议所述。发现切割速率和噪声暴露之间存在强相关性。如果切割速率继续增加,应注意确保由此产生的噪声暴露不会威胁玻璃体视网膜外科医生和手术室工作人员的听力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13d3/10496806/3d6bdd47d383/10.1177_24741264231172564-fig1.jpg

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