Noise Levels and Their Association with Surgical Complexity and Communication in Otolaryngology Sub-specialty Operating Rooms: A Prospective, Single Institution Study

Objectives: This prospective study aimed to assess noise levels in otolaryngology operating rooms (OR), explore noise variation across subspecialties, and examine the correlation between noise, verbal communication, and surgery complexity. Study Design: Prospective trial. Setting: Single academic institution. Methods: Noise levels and surgeon feedback from 60 otolaryngology surgeries at a Tertiary Academic Medical Center were collected between May 2023 and March 2024. Cases were randomly selected based on staff availability, excluding emergency surgeries. The cohort included 13 general ENT, 13 facial plastics, 8 head and neck, 13 laryngology, and 13 rhinology surgeries. Noise data was recorded with a Curconsa Sound Level Meter SL720. Surgeons reported communication ease and case complexity via survey, with communication deemed impaired with the incidence of repeated information in the OR. Case complexity was rated from grade 1 (lowest) to grade 4 (highest). Results: Noise differences between subspecialties’ ORs were statistically significant (p < 0.001), but the Effect size was small (η² ≈ 0.04). The Rhinology OR showed higher average noise levels compared to Facial Plastic (Rhinology louder by ~2.2 dB) and Head-Neck (Rhinology louder by ~2.6 dB). Noise did not significantly impair communication in the OR (p=0.526). Higher noise in the OR did not significantly influence surgical complexity (p=0.547). Conclusion: Noise levels in otolaryngology operating rooms varied modestly across subspecialties. No significant association between noise levels and either communication impairment or surgical complexity was observed.