Abstract
AimTo determine the loudness of suctioning in the ear canal with different-sized suctions and various mediums. Aural microsuctioning is commonly used in the otolaryngologist’s office setting for cerumen removal and aural toilet. We hypothesize that the intensity of the sound would increase with increasing viscosity of the medium and increasing suction diameter.MethodsThe intensity of the sound generated was measured while suctioning air, water, and yogurt on cadaveric temporal bones with size 7 and 5 Frazier suctions. This was performed with one measurer and one operator. Under otomicroscopy, the operator would suction the ear canal and the measurer would record the intensity of the sound with a sound decibel meter placed at the lateral and posterior external auditory canal. Data was collected with two separate operators and measurers to aid with inter-rater reliability.ResultsThere was a total of 240 repeated observations (10 cadavers, 3 mediums, 2 suction devices; 2 investigators). The range of the maximum peak intensity ranged from 63.0 dB to 100.0 dB. The lowest peak intensity of decibels was recorded in air with the size 5 Frazier suction; and the highest measured was with the size 5 Frazier suction in yogurt. Statistically significant differences were found only in the measurements in air.ConclusionOur investigation found that increasing peak sound intensities were generated by increasing the viscosity of the fluid medium that was being suctioned. However, the smaller sized diameter suction actually generated louder sound intensities than the larger diameter suction with higher viscosity fluid media, but this was not statistically significant.
Highlights
A large percentage of patients who present to the otolaryngologist require routine ear cleaning for multiple reasons, including cerumen impaction, otorrhea secondary to otitis externa, otitis media, and various other etiologies
The loudness of suctioning in the ear canal was measured with air, water, and yogurt to replicate infection, cerumen, and other ear canal debris that are normally seen in patients
When testing if there were statistically significant differences in decibels by suctions sizes in each medium, we only found differences in the measurements performed in air (Table 1)
Summary
A large percentage of patients who present to the otolaryngologist require routine ear cleaning for multiple reasons, including cerumen impaction, otorrhea secondary to otitis externa, otitis media, and various other etiologies. Otolaryngologists routinely clean out patients’ ears using strategies that include otomicroscopy with a curette, alligator forceps, and suction. Newer ear cleaning strategies include soaking the canal with hydrogen peroxide or saline solution, which can aid with removal [1]. Suctioning out fluid from the ear canal can be loud and uncomfortable, and the larger the diameter of the Frazier-type suction, the more powerful and louder the suction. We routinely use a size 7 Frazier suction in the ear canal, but as we move closer to the tympanic membrane, we tend to transition to smaller sized suctions such as a size 5 or 3. The speed of sound travels fastest through solids because molecules are more densely packed together
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