In advanced otological surgeries, powered instruments form an indispensable part. The risk of deterioration to hearing in the operated ear is a commonly discussed issue, however, there remains a possibility of affecting the hearing in the contralateral ear due to transcranial vibration. So in this study we aimed to assess the possibility of the non-operated ear being affected by the noise generated during ear surgeries and whether it is temporary or permanent in nature. Methodology: This study included 63 patients diagnosed with unilateral disease who underwent mastoid surgery. Preoperatively all the patients were subjected to Pure tone audiometry (PTA), Transient evoked otoacoustic emission (TEOAE) and Distortion product otoacoustic emission (DPOAE). Patients were operated using both cutting and diamond burrs of ranging from sizes 1 - 6 mm. Total drilling time was recorded. Results: Post-operative hearing evaluation was done at 1 week, 4 weeks and 12 weeks. The sound emitted by various burrs was recorded by Sound Level Meter. Out of the total 58 patients that followed up, 46 showed change in at least one of the hearing parameters. Patients showing changes had a higher drilling time as compared to those with no changes. Of these, the changes associated with the total drilling time and with cutting burr time were found to be significant. The hearing changes seen on PTA, TEOAE and DPOAE were transient in nature with only one patient having a persistent decreased high frequency threshold at the end of 12 weeks. It was also found that cutting burrs produce more sound as compared to diamond burrs and a larger size burr of a type produces more sound than a smaller one of its type. Conclusion: The drilling of mastoid bone during ear surgeries can transiently impair the hearing in the contralateral ear which is of great significance in patients with only one hearing ear.
References
[1]
Schwartze, H.H. and Eysell, C.G. (1873) Ueber die kunstliche Eroffnung des Warzenfortsatzes. Archiv für Ohrenheilkunde, 7, 157-162. https://doi.org/10.1007/BF01803976
[2]
Zaulfal, E. (1893) Technik der trepanationdes proc. mastoid. Nach kuster’schen grundsatzen. Arch Ohrenheilkd, 30, Article 291.
[3]
Krampe, C. (1984) Zeiss Operating Microscopes for Neurosurgery. Neurosurgical Review, 7, 89-97. https://doi.org/10.1007/BF01780690
[4]
Jansen, C. (1958) Raikaloperation and Typanplastik. Sitz Per Fortbild Anztekamn Oh, 18.
[5]
Kylén, P., Stjernvall, J.-E. and Arlinger, S. (1977) Variables Affecting the Drill-Generated Noise Levels in Ear Surgery. Acta Oto-Laryngologica, 84, 252-259. https://doi.org/10.3109/00016487709123964
[6]
Holmquist, J., Oleander, R. and Hallén, O. (1979) Peroperative Drill-Generated Noise Levels in Ear Surgery. Acta Oto-Laryngologica, 87, 458-460. https://doi.org/10.3109/00016487909126451
[7]
Eddins, A.C., Zuskov, M. and Salvi, R.J. (1999) Changes in Distortion Product Otoacoustic Emissions during Prolonged Noise Exposure. Hearing Research, 127, 119-128. https://doi.org/10.1016/S0378-5955(98)00182-8
[8]
Man, A. and Winerman, I. (1985) Does Drill Noise during Mastoid Surgery Affect the Contralateral Ear? American Journal of Otolaryngology, 6, 334-335.
[9]
Da Cruz, M.J., Fagan, P., Atlas, M. and McNeill, C. (1997) Drill-Induced Hearing Loss in the Nonoperated Ear. Otolaryngology-Head and Neck Surgery, 117, 555-558. https://doi.org/10.1016/S0194-59989770030-5
[10]
Urquhart, A.C., McIntosh, W.A. and Bodenstein, N.P. (1992) Drill-Generated Sensorineural Hearing Loss Following Mastoid Surgery. The Laryngoscope, 102, 689-692. https://doi.org/10.1288/00005537-199206000-00016
[11]
Hegewald, M., Heitman, R., Wiederhold, M.L., Cooper, J.C. and Gates, G.A. (1989) High-Frequency Electrostimulation Hearing after Mastoidectomy. Otolaryngology-Head and Neck Surgery, 100, 49-56. https://doi.org/10.1177/019459988910000108
[12]
Kylén, P., Arlinger, S.D. and Bergholtz, L.M. (1977) Peroperative Temporary Threshold Shift in Ear Surgery an Electrocochleographic Study. Acta Oto-Laryngologica, 84, 393-401. https://doi.org/10.3109/00016487709123982
[13]
Karatas, E., Miman, M.C., Ozturan, O., Erdem, T. and Kalcioglu, M.T. (2007) Contralateral Normal Ear after Mastoid Surgery: Evaluation by Otoacoustic Emissions (Mastoid Drilling and Hearing Loss). ORL: Journal for Oto-Rhino-Laryngology and Its Related Specialties, 69, 18-24. https://doi.org/10.1159/000096712
[14]
Dan, J., Bibas, A., Santuli, C., Donnelly, N., Jeronimidis, G. and Oconnor, A.F. (2007) Equivalent Noise Level Generated by Drilling Onto the Ossicular Chain as Measured by Laser Doppler Vibrometry: A Temporal Bone Study. The Laryngoscope, 117, 1040-1045. https://doi.org/10.1097/MLG.0b013e3180459a10
[15]
Domenech, J., Carulla, M. and Traserra, J. (1989) Sensorineural High Frequency Hearing Loss after Drill-Generated Acoustic Trauma in Tympanoplasty. Archives of oto-rhino-laryngology, 246, 280-282. https://doi.org/10.1007/BF00463575
Schick, B., Schick, B.T., Kochannek, S., Starlinger, V. and Iro, H. (2007) Temporary Sensory Hearing Deficits after Ear Surgery—A Retrospective Analysis. Laryngorhinootologie, 86, 200-205. https://doi.org/10.1055/s-2006-944750
[18]
Gjuric, M., Schneider, W., Buhr, W., Wolf, S.R. and Malte, E.W. (1997) Experimental Sensorineural Hearing Loss Following Drill-Induced Ossicular Chain Injury. Acta Oto-Laryngologica, 117, 497-500. https://doi.org/10.3109/00016489709113427
[19]
Wolfgang, S. and Mislav, G. (1999) The Value of Methylpredinsolone in the Treatment of Experimental Sensorineural Hearing Loss Following Drill Induced Ossicular Chain Injury in Guinea Pigs. Acta Oto-Laryngologica, 41, 281-290.
[20]
Tos, M., Lau, T. and Plate, S. (1984) Sensorineural Hearing Loss Following Chronic Ear Surgery. Annals of Otology, Rhinology & Laryngology, 93, 403-409. https://doi.org/10.1177/000348948409300424
[21]
Hickey, S.A. and O’Connor, A.F. (1991) Measurement of Drill-Generated Noise Levels during Ear Surgery. The Journal of Laryngology & Otology, 105, 732-735. https://doi.org/10.1017/S0022215100117153
[22]
Kylen, P. and Arlinger, S. (1976) Drill-Generated Noise Levels in Ear Surgery. Acta Oto-Laryngologica, 82, 402-409. https://doi.org/10.3109/00016487609120925
[23]
Parkin, J.L., Wood, G.S., Wood, R.D. and McCandless, G.A. (1980) Drill-and Suction-Generated Noise in Mastoid Surgery. Archives of Otolaryngology, 106, 92-96. https://doi.org/10.1001/archotol.1980.00790260024008
[24]
Yin, X.H., Stromberg, A.-K. and Duan, M. (2011) Evaluation of the Noise Generated by Otological Electrical Drills and Suction during Cadaver Surgery. Acta Oto-Laryngologica, 131, 1132-1135. https://doi.org/10.3109/00016489.2011.600725
[25]
Pye, A. and Ulehlova, L. (1989) A Comparison of Initial and Permanent Surface Changes to Guinea Pig Hair Cells after Plastic Acoustic Overstimulation. Archives of oto-rhino-laryngology, 246, 3-10. https://doi.org/10.1007/BF00454127
[26]
Stockwell, C.W., Ades, H.W. and Engstrom, H. (1969) Pattern of Hair Cell Damage after Intense Auditory Stimulation. Annals of Otology, Rhinology & Laryngology, 78, 1144-1168. https://doi.org/10.1177/000348946907800602
[27]
Strömberg, A.-K., Yin, X.H., Olofsson, A. and Duan, M. (2010) Evaluation of the Usefulness of a Silicone Tube Connected to a Microphone in Monitoring Noise Levels Induced by Drilling during Mastoidectomy and Cochleostomy. Acta Oto-Laryngologica, 130, 1163-1168. https://doi.org/10.3109/00016481003743050
[28]
Michaelides, E.M. and Kartush, J.M. (2001) Implications of Sound Levels Generated by Otologic Devices. Otolaryngology-Head and Neck Surgery, 125, 361-363. https://doi.org/10.1067/mhn.2001.118956
[29]
Helms, J. (1976) Acoustic Trauma from the Bone Cutting Burr. The Journal of Laryngology & Otology, 90, 1143-1149. https://doi.org/10.1017/S0022215100083225
[30]
Pau, H.W., Leitner, H. and Hartwein, J. (1991) Bohrer-Berührung des Trommelfells mit bei Ohroperationen: Möglichkeit der Innenohrschädigung? In: Fleischer, K. and Kleinsasser, O., Eds., Teil II: Sitzungsbericht. Verhandlungsbericht der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf-und Hals-Chirurgie, Vol. 1991/2, Springer, Berlin, Heidelberg, 297-300. https://doi.org/10.1007/978-3-642-84592-5_251
[31]
Schneider, W., Gjuric, M., Katalinic, A., Buhr, W. and Wolf, S.R. (1998) The Value of Methylprednisolone in the Treatment of an Experimental Sensorineural Hearing Loss Following Drill-Induced Ossicular Chain Injury: A Randomized, Blinded Study in Guinea-Pigs. Acta Oto-Laryngologica, 118, 52-55. https://doi.org/10.1080/00016489850155125
[32]
El-Hennawi, D.M., Badr El-Deen, M.H., Abou-Halawa, A.S., Nadeem, H.S. and Ahmed, M.R. (2005) Efficacy of Intratympanic Methylprednisolone Acetate in Treatment of Drill Induced Sensorineural Hearing Loss in Guinea Pigs. The Journal of Laryngology & Otology, 119, 2-7. https://doi.org/10.1258/0022215053222815
[33]
Scheibe, F., Haupt, H. and Ising, H. (2000) Preventive Effect of Magnesium Supplement on Noise-Induced Hearing Loss in the Guinea Pig. European Archives of Oto-Rhino-Laryngology, 257, 10-16. https://doi.org/10.1007/PL00007505
[34]
Tos, M., Trojaborg, N. and Thomsen, J. (1989) The Contralateral Ear after Translabyrinthine Removal of Acoustic Neuromas: Is There a Drill Noise Generated Hearing Loss? The Journal of Laryngology & Otology, 103, 845-849. https://doi.org/10.1017/S0022215100110278
[35]
Gowda, B.V.C. and Mathew, S.A. (2015) Evaluation of Drill Generated Acoustic Trauma on the Non-Operated Ear Following Mastoid Surgery. International Journal of Scientific Research, 4, 602-604.
[36]
Goyal, A., Singh, P.P. and Vashishth, A. (2013) Effect of Mastoid Drilling on Hearing of the Contralateral Ear. The Journal of Laryngology & Otology, 127, 952-956. https://doi.org/10.1017/S0022215113001965
[37]
Paksoy, M., Sanli, A., Hardal, U., Kibar, S., Altin, G., Erdogan, B.A. and Bekmez, Z.E. (2012) How Drill-Generated Acoustic Trauma Effects Hearing Functions in an Ear Surgery? International Journal of Head Neck Surgery, 3, 127-132. https://doi.org/10.5005/jp-journals-10001-1112
[38]
Desai, A.A., Aiyer, R.G., Pandya, V.K. and Unnikrishnan, N. (2004) Postoperative Sensorineural Hearing Loss after Middle Ear Surgery. Indian Journal of Otolaryngology and Head and Neck Surgery, 56, 240-242. https://doi.org/10.1007/BF02974364
[39]
Palva, A. and Sorri, M. (1979) Can an Operation of Deaf Ear Be Dangerous for Hearing? Acta Oto-Laryngologica, 360, 155-157. https://doi.org/10.3109/00016487809123503
[40]
Migirov, L. and Wolf, M. (2007) Influence of Drilling on the Distortion Product Otoacoustic Emissions in the Non-Operated Ear. ORL: Journal for Oto-Rhino-Laryngology and Its Related Specialties, 71, 153-156. https://doi.org/10.1159/000218741
[41]
Karimi, Y.A., Sadeghi, M., Nadimi, T.A., et al. (2004) Effect of Drill Induced Hearing Loss in the Non-Operated Ear after Mastoidectomy by Measuring of Otoacoustic Emission. Tehran University of Medical Sciences Journals, 62, 10-15.
[42]
Zou, J., Bretlau, P., Starck, J., Toppila, E. and Pyykkö, I. (2001) Sensorineural Hearing Loss after Vibration: An Animal Model for Evaluating Prevention and Treatment of Inner Ear Hearing Loss. Acta Oto-Laryngologica, 121, 143-148. https://doi.org/10.1080/000164801300043244
