title: Noise levels within the ear and post-nasal space in neonates in intensive care.
abstract: BACKGROUND
  Noise exposure in neonatal units has long been suspected of being a cause of hearing loss associated with such units. The noise intensity to which the neonate is exposed varies with the type of ventilatory support used. Also, the post-nasal space is an enclosed cavity that is close to the inner ear and an area of turbulent and hence potentially noisy airflow.
  
  
  OBJECTIVE
  To determine noise intensities within the ear and post-nasal space in neonates on different modes of ventilatory support using probe microphones, measures previously not undertaken.
  
  
  METHODS
  A portable instrument with a probe microphone was used for the measurements. Three groups of infants were included: (a) those receiving no respiratory support (NS); (b) those receiving conventional ventilation (CV); (c) those receiving continuous positive airways pressure (CPAP) support.
  
  
  RESULTS
  The mean in-the-ear noise intensities (at 1 kHz) were 41.7 dB SPL (NS), 39.5 dB SPL (CV), and 55.1 dB SPL (CPAP). The noise intensities in the post-nasal space in those receiving CPAP support were higher than in the other groups, reached mean levels of up to 102 dB SPL at some frequencies, and increased with increasing flow rates.
  
  
  CONCLUSIONS
  The most important finding is the high noise intensities in the post-nasal space of those receiving CPAP support. Given the proximity of the post-nasal space to the inner ear, enough noise could be transmitted, especially in infants receiving the higher flow rates, to cause cochlear damage and hence hearing loss. It would therefore be wise, wherever possible, to avoid using the higher flow rates.
authors.affiliation: Department of Audiological Medicine and Neuro-otology, Medway Maritime Hospital, Kent, UK.
authors.forename: S S
authors.initials: SS
authors.lastname: Surenthiran
authors.forename: K
authors.initials: K
authors.lastname: Wilbraham
authors.forename: J
authors.initials: J
authors.lastname: May
authors.forename: T
authors.initials: T
authors.lastname: Chant
authors.forename: A J B
authors.initials: AJ
authors.lastname: Emmerson
authors.forename: V E
authors.initials: VE
authors.lastname: Newton
mesh_terms: D003051:Cochlea / Q000293:injuries; D004423:Ear; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D006317:Hearing Loss, Noise-Induced; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D009622:Noise; D009666:Nose; D011175:Positive-Pressure Respiration; D013997:Time Factors; D012122:Ventilators, Mechanical / Q000009:adverse effects*