Does drill-induced noise have an impact on sensorineural hearing during craniotomy procedure?

Farzanegan, Gholamreza; Masoud, Ghasemi; Panahi, F; Raza, Mohsin; Alghasi, Mohsen

doi:10.3109/02688690903374059

Cited by 22 publications

(20 citation statements)

References 14 publications

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“…6 Farzanegan et al showed that patients undergoing supratentorial craniotomy for brain tumor resection developed SNHL that was restricted to the higher frequencies. 8 Despite taking precautions to reduce operative trauma to the vestibulocochlear nerve, using a retractorless technique, a small number of patients in this study did have HFHL following MVD. While some of the HFHL observed may be due to operative manipulation that can never be truly avoided, drill-induced acoustic damage remains a possible etiology in these patients.…”

Section: Drill-induced Snhlmentioning

confidence: 99%

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Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm

Frederickson

Balzer

Crammond

et al. 2015

JNS

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M icrovascular decompression (MVD) is a safe and efficacious procedure for the treatment of hemifacial spasm (HFS), a debilitating condition that reduces patients' quality of life. Severe sensorineural hearing loss (SNHL) across all frequencies is a known complication of the operation, with reported rates ranging from 1.4% to 20%. 4,12,[18][19][20][21]24 In addition to severe SNHL, however, a recent report has raised concern that as many as one-half of patients undergoing MVD for HFS may experience high-frequency (4-8 kHz) hearing loss.28 Although this type of hearing loss is not as obviously apparent upon clinical follow-up as severe SNHL, high-frequency hearing loss (HFHL) can profoundly reduce the quality of life of patients. 5,10 Although the prior report implicated noise from the high-speed surgical drill as the cause of HFHL following MVD, we conducted this study to examine the incidence of HFHL, with an emphasis on retractorless MVD for treatment of HFS.abbreviatioNs BAEP = brainstem auditory evoked potential; HFHL = high-frequency hearing loss; HFS = hemifacial spasm; MVD = microvascular decompression; SNHL = sensorineural hearing loss; SPL = sound pressure level. obJect Microvascular decompression is a safe and effective procedure to treat hemifacial spasm, but the operation poses some risk to the patient's hearing. While severe sensorineural hearing loss across all frequencies occurs at a low rate in experienced hands, a recent study suggests that as many as one-half of patients who undergo this procedure may experience ipsilateral high-frequency hearing loss (HFHL), and as many as one-quarter may experience contralateral HFHL. While it has been suggested that drill-related noise may account for this finding, this study was designed to examine the effect of a number of techniques designed to protect the vestibulocochlear nerve from operative manipulation on the incidence of HFHL. methods Pure-tone audiometry was performed both preoperatively and postoperatively on 67 patients who underwent microvascular decompression for hemifacial spasm during the study period. A change of greater than 10 dB at either 4 kHz or 8 kHz was considered to be HFHL. Additionally, the authors analyzed intraoperative brainstem auditory evoked potentials from this patient cohort. results The incidence of ipsilateral HFHL in this cohort was 7.4%, while the incidence of contralateral HFHL was 4.5%. One patient (1.5%; also included in the HFHL group) experienced an ipsilateral nonserviceable hearing loss. coNclusioNs The reduced incidence of HFHL in this study suggests that technical modifications including performing the procedure without the use of fixed retraction may greatly reduce, but not eliminate, the occurrence of HFHL following microvascular decompression for hemifacial spasm.

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Section: Drill-induced Snhlmentioning

confidence: 99%

“…8,28 Drill-generated noise may damage hearing by either mechanical stretch of the inner-ear structures or through metabolic changes in the cochlear cells. 6 Farzanegan et al showed that patients undergoing supratentorial craniotomy for brain tumor resection developed SNHL that was restricted to the higher frequencies.…”

Section: Drill-induced Snhlmentioning

confidence: 99%

Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm

Frederickson

Balzer

Crammond

et al. 2015

JNS

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“…3 When a drill is used during a mastoid surgery, the noise level in the cochlea is calculated from vibration measurements on intact skulls of human cadavers and temporal bones. 4 Everytime when a drill is used, the ipsilateral cochlea is exposed to noise levels of about 100 dB and the contralateral cochlea to levels of 5 to 10 dB lower. 5 For example, when drilling in the mastoid cavity, the noise levels range from 85 to 117 dB.…”

Section: Introductionmentioning

confidence: 99%

How Drill-Generated Acoustic Trauma effects Hearing Functions in an Ear Surgery?

Paksoy¹,

Şanli²,

Hardal³

et al. 2012

International Journal of Head and Neck Surgery

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Objective: In otology, a wide variety of devices are used that have significant noise output, both operated ear and the patient. We aimed to determine hearing damages due to drill-generated acoustic trauma in ear surgery. We want to find how degree drill-generated acoustic trauma is responsible from sensorineural hearing loss in ear surgery. Materials and methods:We designed a retrospective study about 100 patients who underwent radical or modiphied radical mastoidectomy and tympanoplasty. The audiometric testing was done both pre and postoperatively to detect any significant hearing loss in the immediate postoperative period. The data were analyzed using the Wilcoxon sign and Mann-Whitney U tests. This study proposes that hearing loss is caused by drill noise conducted to the operated ear by vibrations of temporal bone.Results: A sensorineural hearing loss soon after mastoid surgery is seen due to the noise generated by the drill. Mean pure-tone thresholds obtained was significantly more in mastoidectomy applied patients when compared to tympanoplasty . Mean bone conduction (BC) hearing levels impaired 6,6 dB in 1 kHz ,5.5 dB in 0.5 kHz , 5 dB in 4.kHz and 3.1 dB in 2 kHz in mastoidectomy groups but improved 5.5 dB in 0.5 kHz, 2.2 dB in 1 kHz , 2.7 dB in 2 kHz in tympanoplasty groups. Statistically significant differences were observed at the 0.5-1 and 4 kHz frequencies pre and postoperative in the hearing thresholds of BC changing in mastoidectomy group, however, the averages of ranks of all pre and postoperative measurement of hearing levels show differences between mastoidectomy and tympanoplasty groups was significant in statistically at independent groups (p < 0.05). Conclusion:We conclude that drill-generated noise during mastoid surgery has been incriminated as a cause of sensorineural hearing loss. Drilling during mastoid surgery may result in temporary or permanent noise-induced hearing loss. Possible noise disturbance to the inner ear can only be avoided by minimizing the duration of harmful noise exposure and carefull using burr to near the cochlear structures.

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“…9,20 Similar results were also reported in asso- ciation with elective craniotomy when audiograms were performed before and after the procedure. 7 These studies found that drill-generated noise during craniotomy significantly affected high-frequency (4-6 kHz) but not lowfrequency (0.25-2 kHz) hearing. As noted, the short outer hair cells of the high-frequency region have been found to be more vulnerable to sound stimulation than the taller receptor cells in the low-frequency area.…”

Section: Discussionmentioning

confidence: 99%

The incidence of high-frequency hearing loss after microvascular decompression for trigeminal neuralgia, glossopharyngeal neuralgia, or geniculate neuralgia

Meigh

Dasyam²,

Shankar³

et al. 2015

JNS

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S enSorineural hearing loss after microvascular decompression (MVD) has a reported incidence of 1%-23.8% when performed for trigeminal neuralgia (TGN), 1.5%-4.2% for glossopharyngeal neuralgia (GPN), and 22% for geniculate neuralgia (GN). 21,24,25,27 Because of the proximity of the cranial nerve VIII to cranial nerves decompressed during the procedure, the auditory nerve in many patients is often stretched or damaged, resulting in hearing impairment. Although sensorineural hearing loss after MVD is frequently documented and well understood, high-frequency hearing loss (HFHL) is currently not well recognized. HFHL has been recently reported after MVD for hemifacial spasm (HFS). . disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. obJect The primary aim of this study was to evaluate the incidence and discuss the pathogenesis of high-frequency hearing loss (HFHL) after microvascular decompression (MVD) for trigeminal neuralgia (TGN), glossopharyngeal neuralgia (GPN), or geniculate neuralgia (GN). methods The authors analyzed preoperative and postoperative audiogram data and brainstem auditory evoked potentials (BAEPs) from 93 patients with TGN, 6 patients with GPN, and 8 patients with GN who underwent MVD. Differences in pure tone audiometry > 10 dB at frequencies of 0.25, 0.5, 1, 2, 4, and 8 kHz were calculated preoperatively and postoperatively for both the ipsilateral and the contralateral sides. Intraoperative monitoring records were analyzed and compared with the incidence of HFHL, which was defined as a change in pure tone audiometry > 10 dB at frequencies of 4 and 8 kHz. results The incidence of HFHL was 30.84% on the side ipsilateral to the surgery and 20.56% on the contralateral side. Of the 47 patients with HFHL, 20 had conductive hearing loss, and 2 experienced nonserviceable hearing loss after the surgery. The incidences of HFHL on the ipsilateral side at 4 and 8 kHz were 17.76% and 25.23%, respectively, and 8.41% and 15.89%, respectively, on the contralateral side. As the audiometric frequency increased, the number of patients with hearing loss increased. No significant postoperative difference was found between patients with and without HFHL in intraoperative BAEP waveforms. Sex, age, and affected side were not associated with an increase in the incidence of hearing loss. coNclusioNs High-frequency hearing loss occurred after MVD for TGN, GPN, or GN, and the greatest incidence occurred on the ipsilateral side. This hearing loss may be a result of drill-induced noise and/or transient loss of cerebrospinal fluid during the course of the procedure. Changes in intraoperative BAEP waveforms were not useful in predicting HFHL after MVD. Repeated postoperative audiological examinations may be useful in assessing the prognosis of HFHL.

show abstract

Does drill-induced noise have an impact on sensorineural hearing during craniotomy procedure?

Abstract: We conclude that drill-generated noise during craniotomy has been incriminated as a cause of SNHL. Possible noise disturbance to the inner ear can only be avoided by minimizing the number of burr holes and the duration of harmful noise exposure to the cochlear structures.

Cited by 22 publications

References 14 publications

Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm

Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm

How Drill-Generated Acoustic Trauma effects Hearing Functions in an Ear Surgery?

The incidence of high-frequency hearing loss after microvascular decompression for trigeminal neuralgia, glossopharyngeal neuralgia, or geniculate neuralgia

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