The Effect of Ear Covering on Sound Localization and Speech Intelligibility in Operating Room

Objective: To determine the effect of the surgical bouffant cap on hearing, sound localization, and speech intelligibility in the operating room (OR). Background: Covering of the ear during surgical procedures has been promoted to prevent surgical site infection (SSI) from ear pathogens. However, the potential impact of ear covering on hearing in the OR has not been studied. Methods: Twenty participants with normal hearing underwent auditory testing with and without surgical attire (bouffant cap and surgical mask). Auditory threshold testing was performed with warble tones in a sound-treated booth. In the speech intelligibility test, participants were instructed to identify the last word of Speech Perception in Noise (SPIN) sentences (high and low predictability) in OR background noise. In the sound source localization test, participants were asked to localize a speech source amidst OR background noise. Results: Threshold measures showed no significant effect of wearing surgical attire on detection thresholds. Wearing surgical attire significantly impaired speech intelligibility (p < 0.05). Sound localization was not statistically significant. Conclusions: The use of the surgical bouffant cap and mask makes it more difficult to understand speech in the presence of OR noise. This could lead to miscommunication and impact surgical outcome; thus, ear covering should be avoided. Level of Evidence: N/A Laryngoscope, 2024.