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

## TL;DR

This study found that using surgical smoke evacuators during adenotonsillectomy increases noise levels in the OR, potentially risking hearing loss for surgical staff.

## Contribution

The study provides empirical evidence that aerosol mitigation equipment increases intraoperative noise beyond safe occupational limits.

## Key findings

- Mean sound levels with the SSE were 72 ± 3 dBA, significantly higher than 68 ± 2 dBA without it.
- Maximum noise levels with SSE reached 82 ± 3 dBA, exceeding international standards for concentration-based work.

## 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.