Investigation of noise levels generated by otologic drills

Drilling during temporal bone surgery may result in temporary or permanent noise-induced hearing loss or tinnitus. This has practical implications for both the patient and the surgeon. Different surgical drill devices, routinely used in temporal bone surgery, are examined referring to their emitted sound levels and sound transport. Two surgical drills were used on a brass tubing and a steel wire to simulate sound generation during temporal bone surgery. Overview measurements were performed on human cadaver in a medical laboratory. A set-up in a silent chamber was chosen to exclude external sound sources. The noise emissions and the vibration generated by a silver diamond bur and a cutting drill (Rose bur) were registered when used on a brass tubing and a solid steel wire with sound level meter and a non-contact laser vibrometer. The highest sound rate generated by the diamond burr did not exceed 63 dB(A) when used on a solid steel wire, whereas the cutting burr emitted 76 dB(A). Both drills produced lower sound levels on the brass tubing. Again the cutting burr topped the diamond burr with 68 dB(A) against 56 dB(A). The sound emission did not exceed 76 dB(A) outside a radius 4 cm around the drill location. In conclusion, sound emission generated by different surgical burs routinely used in temporal bone surgery is lower than expected. Still, within a small radius around those burs high sound pressure levels may be induced into surrounding structures such as ossicles, labyrinth, and cochlear. Still damage is feasible when using surgical drills for a longer time period close to sensitive structures.