Suction-generated noise in an anatomic silicon ear model


The objectives of this study were to evaluate noise levels generated during micro-suction aural toilet using an anatomic silicon ear model. It is an experimental study. In an anatomic ear model made of silicone, the eardrum was replaced by a 1-cm diameter microphone of a calibrated sound-level measuring device. Ear wax was removed using the sucker of a standard ENT treatment unit (Atmos Servant 5®). Mean and peak sound levels during the suction procedure were recorded with suckers of various diameters (Fergusson-Frazier 2.7–4 mm as well as Rosen 1.4–2.5 mm). Average noise levels during normal suction in a distance of 1 cm in front of the eardrum ranged between 97 and 103.5 dB(A) (broadband noise). Peak noise levels reached 118 dB(A). During partial obstruction of the sucker by cerumen or dermal flakes, peak noise levels reached 146 dB(A). Peak noise levels observed during the so-called clarinet phenomena were independent of the diameter or type of suckers used. Although micro-suction aural toilet is regarded as an established, widespread and usually safe method to clean the external auditory canal, some caution seems advisable. The performance of long-lasting suction periods straight in front of the eardrum without sound-protecting earwax between sucker and eardrum should be avoided. In particular, when clarinet phenomena are occurring (as described above), the suction procedure should be aborted immediately. In the presence of dermal flakes blocking the auditory canal, cleaning with micro-forceps or other non-suctioning instruments might represent a reasonable alternative.

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  1. 1.

    Snelling JD, Smithard A, Wadell A (2009) Noise levels generated within the external auditory canal during microsuction aural toilet and the effect on hearing: a prospective controlled series. Clin Otolaryngol 34:21–25

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Katzke D, Sesterhen G (1982) Suction-generated noise in the external meatus and sensoneurinal hearing loss. J Laryngol Otol 96:857–863

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Hansen S, Stupp A, Schwarze S, Schipper J (2012) Suction generated noise levels during aural toilet. Laryngorhinootologie 91:103–108

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Spencer MG (1980) Suction tube noise and myringotomy. J Laryngol Otol 94:383–386

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Wetmore RF, Henry WJ, Konkle DF (1993) Acoustical factors of noise created by suctioning middle ear fluid. Arch Otolaryngol Head Neck Surg 119:762–766

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Parkin JL, Wood GS, Wood RD et al (1980) Drill and suction-generated noise in mastoid surgery. Arch Otolaryngol 106:92–96

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Mason JDT, Mason SM, Gibbin KP (1995) Raised ABR threshold after suction aspiration of glue from the middle ear: three case studies. J Laryngol Otol 109:726–728

    PubMed  CAS  Google Scholar 

  8. 8.

    Directive 2003/10/Ec of the European Parliament and of the Council of 6 February 2003 on the minimum health and safety requirements regarding the exposure of workers to the risks arising from physical agents (noise) (Seventeenth individual Directive within the meaning of Article 16(1) of Directive 89/391/EEC)

  9. 9.

    Liedtke M (2010) Akute Gehörschäden durch extrem hohe Schalldruckpegel. HNO 58:106–109

    PubMed  Article  CAS  Google Scholar 

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None of the contributing authors have any conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.

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Correspondence to Wolfgang Luxenberger.

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Luxenberger, W., Lahousen, T. & Walch, C. Suction-generated noise in an anatomic silicon ear model. Eur Arch Otorhinolaryngol 269, 2291–2293 (2012).

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  • Aural toilet
  • Micro-suction
  • Noise levels
  • Cerumen