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Acoustic trauma from the bone cutting burr.

The Journal of Laryngology and Otology

|December 1, 1976

Summary

Drilling the ossicular chain causes high stapes footplate movements, exceeding physiological levels. These movements, with high intensity, likely lead to inner ear damage.

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Area of Science:

Otolaryngology
Neurosurgery
Biomedical Engineering

Background:

Understanding the biomechanical effects of surgical drilling on the ossicular chain is crucial for preventing inner ear damage.
The stapes footplate's movement amplitude is a key indicator of potential cochlear trauma during otologic procedures.

Observation:

Human temporal bones were used to measure stapes footplate movements during drilling of the ossicular chain with cutting and diamond burrs.
High amplitude movements were observed, significantly exceeding physiological ranges.

Findings:

The frequency distribution of stapes movements mimicked the dB(A) curve.
The measured intensity surpassed sound pressure levels at the eardrum by over 30 dB, with constant pressure during burr contact.

Implications:

Unphysiological stapes footplate movements generated during drilling pose a significant risk of inner ear damage.
These findings highlight the need for careful surgical technique and potentially modified drilling parameters to protect the inner ear.

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