OR noise: the potential for hearing loss

With the use of the electric or air-powered drill in cranial or spinal procedures comes the potential for hearing loss among operating team members. Exposure to loud noise can result in sensorineural hearing loss, and this loss is a function of sound pressure levels and duration of exposure. Much research has been done regarding the impact of noise-creating devices on patient and user safety in the field of neuro-otology (1, 6). Michaelides and Kartush measured peak and impulse sound pressure levels one centimeter away from their application in the temporal bone in a variety of otologic instruments, including lasers (potassium-titanyl-phosphate, erbium, and carbon dioxide) and drills (microdrill and pneumatic) (4). Only the erbium laser and air-powered cutting drills had impulse and peak sound pressure levels of greater than 100 A-weighted decibels, dBA. Kylen and colleagues found that the noise levels were influenced primarily by the size of the burr; diamond burrs generated less noise than cutting ones and variations in rotation speed had only a slight influence on the noise levels produced (2). Prasad and Reddy recently tested a variety of bone drills and microdebriders used in otolaryngological surgery and found them all to be safe, posing no occupational hazard to the user (7).