Equivalent noise level generated by drilling onto the ossicular chain as measured by laser Doppler vibrometry: A temporal bone study

Background: Inadvertent drilling on the ossicular chain is one of the causes of sensorineural hearing loss (HL) that may follow tympanomastoid surgery. A high-frequency HL is most frequently observed. It is speculated that the HL is a result of vibration of the ossicular chain resembling acoustic noise trauma. It is generally considered that using a large cutting burr is more likely to cause damage than a small diamond burr. Aim: The aim was to investigate the equivalent noise level and its frequency characteristics generated by drilling onto the short process of the incus in fresh human temporal bones. Methods and Materials: Five fresh cadaveric temporal bones were used. Stapes displacement was measured using laser Doppler vibrometry during short drilling episodes. Diamond. and cutting burrs of different diameters were used. The effect of the drilling on stapes footplate displacement was compared with that generated by an acoustic signal. The equivalent noise level (dB sound pressure level equivalent [SPL eq]) was thus calculated. Results: The equivalent noise levels generated ranged from 93 to 125 dB SPL eq. For a 1-mm cutting burr, the highest equivalent noise level was 108 dB SPL eq, whereas a 2.3-mm cutting burr produced a maximal level of 125 dB SPL eq. Diamond burrs generated less noise than their cutting counterparts, with a 2.3-mm diamond burr producing a highest equivalent noise level of 102, dB SPL eq. The energy of the noise increased at the higher end of the frequency spectrum, with a 2.3-mm cutting burr producing a noise level of 105 dB SPL eq at 1 kHz and 125 dB SPL eq at 8 kHz. In contrast, the same sized diamond burr produced 96 dB SPL eq at 1 kHz and 99 dB at 8 kHz. Conclusion:This study suggests that drilling on the ossicular chain can produce vibratory force that is analogous with noise levels known to produce acoustic trauma. For the same type of burr, the larger the diameter, the greater the vibratory force, and for the same size of burr, the cutting burr creates more vibratory force than the diamond burr. The cutting burr produces greater high-frequency than lower-frequency vibratory energy.

Influence of shape and absorbing surface: a numerical study of railway noise barriers

Results are presented of a study of a performance of various track-side railway noise barriers, determined by using a two- dimensional numerical boundary element model. The basic model uses monopole sources and has been adapted to allow the sources to exhibit dipole-type radiation characteristics. A comparison of boundary element predictions of the performance of simple barriers and vehicle shapes is made with results obtained by using the standard U.K. prediction method. The results obtained from the numerical model indicate that modifying the source to exhibit dipole characteristics becomes more significant as the height of the barrier increases, and suggest that for any particular shape, absorbent barriers provide much better screening efficiency than the rigid equivalent. The cross-section of the rolling stock significantly affects the performance of rigid barriers. If the position of the upper edge is fixed, the results suggest that simple absorptive barriers provide more effective screening than tilted barriers. The addition of multiple edges to a barrier provides additional insertion loss without any increase in barrier height.

Multiple-edge noise barriers

A numerical model using boundary element techniques is discussed which enables the insertion loss for various noise barriers of complex profile and surface cover to be calculated. The model is applied to single-foundation noise barriers to which additional side-panels are added to create fork-like profiles. Spectra of insertion loss and mean insertion loss results over a range of receiver positions for a broadband source are presented. It is concluded that ‘multiple-edged’ barriers show a significant increase in acoustic-efficiency over a simple vertical screen. Adding lightweight side-panels would be a relatively inexpensive measure, and one which could be applied to barriers already in existence. This type of barrier would also allow the height of the construction to be kept to a minimum.

Opportunistic assessment of hearing in elderly inpatients

Objective: To determine the prevalence of occult hearing loss in elderly inpatients, to evaluate feasibility of opportunistic hearing screening and to determine subsequent provision of hearing aids. Materials and methods: Subjects (>65 years) were recruited from five elderly care wards. Hearing loss was detected by a ward-based hearing screen comprising patient-reported assessment of hearing disability and a whisper test. Subjects failing the whisper test or reporting hearing difficulties were offered formal audiological assessment. Results: Screening was performed on 51 patients aged between 70 and 95 years. Of the patients, 21 (41%) reported hearing loss and 16 (31%) failed the whisper test. A total of 37 patients (73%) were referred for audiological assessment with 17 (33%) found to have aidable hearing loss and 11 were fitted with hearing aids (22%). Discussion: This study highlights the high prevalence of occult hearing loss in elderly inpatients. Easy two-step screening can accurately identify patients with undiagnosed deafness resulting in significant proportions receiving hearing aids.

Atmospheric response in summer linked to recent Arctic sea ice loss

Since 2007 a large decline in Arctic sea ice has been observed. The large-scale atmospheric circulation response to this decline is investigated in ERA-Interim reanalyses and HadGEM3 climate model experiments. In winter, post-2007 observed circulation anomalies over the Arctic, North Atlantic and Eurasia are small compared to interannual variability. In summer, the post-2007 observed circulation is dominated by an anticyclonic anomaly over Greenland which has a large signal-to-noise ratio. Climate model experiments driven by observed SST and sea ice anomalies are able to capture the summertime pattern of observed circulation anomalies, although the magnitude is a third of that observed. The experiments suggest high SSTs and reduced sea ice in the Labrador Sea lead to positive temperature anomalies in the lower troposphere which weaken the westerlies over North America through thermal wind balance. The experiments also capture cyclonic anomalies over Northwest Europe, which are consistent with downstream Rossby wave propagation