[Suction-generated noise levels during aural toilet]

The use of suction for the removal of foreign bodies or cerumen from the external auditory canal is a common procedure in ENT outpatient centers. Patients' lamentations about high noise levels during microsuction can cause assault charges concerning permanent hearing loss or tinnitus. However, the medical opinion of these cases is difficult because only a small amount of objective data about suction-generated noise is available.

In this study, noise levels of different suction devices were measured under standardized conditions in an artificial model head (HEAD acoustics, Germany). In a second set-up water and lard (instead of cerumen) were suctioned from an artificial external auditory canal, which was coupled with a noise mediator (Mediator 2238, Brüel & Kjaer, Denmark).

There was a significant influence of the inner diameter of the sucker on the noise level. A sucker with a diameter of 1.4 mm generated a noise level of more than 100 dB(A). The suctioning of water generated a maximum noise level of more than 130 dB(LAmax), while the suctioning of lard reached nearly 150 dB(LAmax). The time lapse of both noise and frequency level for lard suctioning was characteristic of a bang.

This study demonstrates objective and reproducible data for suction-generated noise levels and could help to evaluate patients' complaints.