耳外科手术中吸引器产生噪声的评估

目的探讨耳显微外科中电钻产生噪声的大小及其影响因素，以及耳蜗开窗术时噪声的特点。方法采用ER-7c型声级计，对耳显微手术中不同种类和不同规格的电钻在9具尸头的12侧颞骨中产生的噪声进行测量.并分别对噪声的等效声压级的峰值（MAX）和RMS（均方根）值进行统计学分析。结果在9具尸头的12侧颞骨中测量噪声值如下：（1）不同直径的切割钻在乳突骨皮质产生噪声峰值的均值为120.4dBSPL-121.7dBSPL，RMS值为108.3dBSPL-110.6dBSPL；（2）在乳突腔，不同直径的切割钻和金刚钻产生噪声峰值为116.8dBSPL-121.5dBSPL，RMS为105.4dBSPL-110.1dBSPL，其差别无统计学意义：（3）耳蜗开窗术记录噪声峰值在116.0dBSPL-131.5dBSPL，噪声RMS值为108.6dBSPL-124.9dBSPL，并且在3具尸头的3侧颞骨中记录到转动的金刚钻接触鼓阶内骨膜时噪声值超过130dBSPL。结论耳显微手术中电钻转动所产生的噪声值较大，尤其在耳蜗开窗时转动的金刚钻接触鼓阶内骨膜时噪声值更大，足以引起噪声性耳聋。因此改进耳显微手术的技术、缩短内耳受噪声暴露的时间对降低噪声性耳聋的发生率至关重要。

Noise levels generated by suctioning during otological surgeries

Objective To investigate noise levels generated by surgical suctioning and factors affecting such noise levels.Methods An ER-7C Sound Level Meter was used to measure the noise level generated by suctioning with tips of various sizes in 12 fresh human temporal bones.The Max and Rms levels were analyzed.Results The Max and Rms noise levels ranged from 99.9 to 128.7 dB SPL and from 84.8 to 117.2 dB SPL respectively.The noise level increased as the diameter of suction tips increased.The differences among tips of sizes greater than 2 millimeters were however not statistically significant.Conclution Suction-related noise levels during neurotological surgeries can be very high.Use of suction in such procedures should be minimized and suction tips kept away from the cochlea whenever possible to avoid inducing unnecessary inner ear damage by noise.