Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 13;16(5):e60214.
doi: 10.7759/cureus.60214. eCollection 2024 May.

Do Surgical Smoke Evacuators Increase the Risk of Hearing Loss for Operative Personnel During Routine Adenotonsillectomy Surgery?

Taylor G Lackey  1 , Jacqueline Rowley  2 , Tiffany T Pham  1 , Cory D Portnuff  1   3 , Laylaa Ramos  1 , Norman R Friedman  1   2 , Brian W Herrmann  1   2
Affiliations

Do Surgical Smoke Evacuators Increase the Risk of Hearing Loss for Operative Personnel During Routine Adenotonsillectomy Surgery?

Taylor G Lackey et al. Cureus. .

Abstract

Introduction: Aerosol mitigation equipment implemented due to COVID-19 has increased noise levels in the operating room (OR) during otolaryngological procedures. Intraoperative sound levels may potentially place personnel at risk for occupational hearing loss. This study hypothesized that cumulative intraoperative noise exposures with aerosol mitigation equipment exceed recommended occupational noise exposure levels.

Methods: Sound levels generated by the surgical smoke evacuator (SSE) during adenotonsillectomy were measured using a sound level meter and compared to surgery without SSE.

Results: Thirteen adenotonsillectomy surgeries were recorded. Mean sound levels with the SSE were greater than the control (72 ± 3 A-weighted decibels (dBA) vs. 68 ± 2 dBA; p=0.015). Maximum noise levels during surgery with SSE reached 82 ± 3 dBA.

Conclusion: Surgeons performing adenotonsillectomy with aerosol mitigation equipment are exposed to significant noise levels. Intraoperative sound levels exceeded international standards for work requiring concentration. Innovation is needed to reduce cumulative OR noise exposures.

Keywords: adenoidectomy; noise-induced hearing loss; occupational medicine; sensorineural hearing loss; surgical smoke; surgical smoke evacuator; tonsillectomy.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Setup of the SSE
(A) OR setup with SSE. The yellow arrow points to the suction tip of the SSE, positioned next to the patient’s oral cavity. The red rectangle identifies the sound level meter positioned 16 inches equidistant from the surgeon’s shoulder. (B) SSE system with attached tubing. SSE: surgical smoke evacuator, OR: operating room
Figure 2
Figure 2. Sound levels (dBA) during adenotonsillectomy with and without SSE
The mean sound levels generated during the SSE surgery were 72 dBA and 68 dBA without SSE (*p=0.015). The maximum sound levels during the SSE surgery reached 82 dBA compared to 81 dBA (p=0.732). Error bars represent calculated standard deviation. The circle represents an outlier for maximum sound levels without SSE and the upper standard deviation for this condition is flush with the box plot. SSE: surgical smoke evacuator, dBA: A-weighted decibels
Figure 3
Figure 3. Sound levels (dBA) of the boom and portable SSE in a quiet OR
Mean sound levels of 65 dBA and 70 dBA (***p<0.001) and maximum sound levels of 66 dBA and 71 dBA were found for the boom and portable SSE, respectively (***p<0.001). Error bars represent calculated standard deviation. SSE: surgical smoke evacuator, OR: operating room, dBA: A-weighted decibels
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Noise-induced hearing loss. Rabinowitz PM. https://www.aafp.org/pubs/afp/issues/2000/0501/p2749.html. Am Fam Physician. 2000;61:2749–2756. - PubMed
    1. Noise associated with surgical smoke evacuators during dermatologic surgery. Grigoryan KV, Kampp JT. Dermatol Surg. 2021;47:726–727. - PubMed
    1. Noise-induced hearing loss: an occupational medicine perspective. Stucken EZ, Hong RS. Curr Opin Otolaryngol Head Neck Surg. 2014;22:388–393. - PubMed
    1. Physiological effects of sound on the mewborn. Morris BH, Philbin MK, Bose C. https://www.nature.com/articles/7200451 J Perinatol. 2000;20:55–60. - PubMed
    1. Revisiting the NIOSH criteria for a recommended standard: occupational noise exposure. Murphy WJ, Franks JR. J Acoust Soc Am. 2002;10:2397.

LinkOut - more resources