FFP3 Respirators and Ears - Effects on Middle Ear Pressure and Hearing

NCT ID: NCT05222230

Last Updated: 2022-05-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-23

Study Completion Date

2022-12-31

Brief Summary

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This is Prospective Basic Science Study whose aims are as follows:

1. To determine the effect of Filtering Facepiece (FFP3M) respirators on eustachian tube function and hearing
2. To evaluate the extent to which FFP3M respirators attenuate speech in decibels

The outcome measures are as follows:

1. Changes in baseline pure tone audiometry and tympanometry post intervention.
2. SNOT-22 Questionnaires before and after use of respirator
3. ETDQ7 questionnaire
4. Measurement of speech attenuation in decibels.

Detailed Description

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The use of facemasks is one of the key strategies for reducing human to human transmission of SARS-CoV-2. There is a variety of facemasks worn in the clinical environment ranging from simple facemasks to devices such as filtering face piece 3M (FFP3M) respirators which are mandatory for some clinicians performing aerosol generating procedures (AGPs.)

It has been shown that wearing face protective equipment attenuates sound causing decay in speech intelligibility, especially transmission of middle-to-high voice frequencies.It has been shown that wearing surgical masks results in up to 23.3% loss of speech intelligibility in noisy environments with advanced face personal protective equipment such as FFP3M devices, accounting for up to 69.0% reduction of speech intelligibility. A reduction in speech intelligibility leads to reduced understanding which may result in miscommunication thereby compromising patient safety. To date, there have been two critical incidents in our department due to miscommunication attributed to wearing FFP3M respirators.

Anecdotally, clinicians have reported nasal congestion and subjective hearing loss during FFP3M respirator usage and after, especially when they are worn for a prolonged period of time. Clinicians working in theatre may be required to wear these devices for a number of hours when involved with AGPs.

The secondary consequences of wearing FFP3M respirators for prolonged periods of time, especially in a theatre setting require scientific exploration. This study aims to investigate the effect of FFP3M respirators on middle ear pressure and hearing, and the extent to which FFP3M respirators attenuate sound. Investigators believe that a reduction in speech intelligibility is not the only explanation for the perception of hearing loss when using FFP3M respirators. Investigators postulate that a transient dysfunction in the eustachian tube pressure regulating system also contributes to hearing loss.

To test this hypothesis, investigators will measure hearing and middle ear pressure using pure tone audiometry and tympanometry before and during FFP3M usage. Investigators will also use SNOT-22 and ETDQ7 questionnaires which are validated patient reported outcome measures for nasal symptoms and eustachian tube function. Investigators hope that this study provides some understanding of the physiological effects of FFP3M respirators on hearing and sinonasal symptoms and improves our understanding of their impact on clinical practice. There are no current studies looking into the effects of FFP3M respirators on eustachian tube function.

Conditions

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Eustachian Tube Dysfunction Hearing Disorders Nasal Obstruction

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Prospective open label basic science study.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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FFP3 Respirator

Participants will wear FFP3 respirators during the study.

Group Type EXPERIMENTAL

FFP3 Mask

Intervention Type OTHER

Participans will wear FFP3 respirators during the study.

Interventions

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FFP3 Mask

Participans will wear FFP3 respirators during the study.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Healthcare workers that already have their own masks, fitted and provided by the Trust for day-to-day clinical use
* Participants without pre-existing sinonasal symptoms or previous sinonasal surgery
* Participants without pre-existing hearing loss or a history of otological procedures

Exclusion Criteria

* Participants with pre-existing sinonasal symptoms or previous sinonasal surgery
* Participants with pre-existing hearing loss or a history of otological procedures
* Participants who do not satisfy the requirements set out in the pre-registration questionnaire
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Liverpool University Hospitals NHS Foundation Trust

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Central Contacts

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Nazia Munir, FRCS ORL-HNS

Role: CONTACT

07970921448

Todd Kanzara, FRCS ORL-HNS

Role: CONTACT

07796945100

References

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Corey RM, Jones U, Singer AC. Acoustic effects of medical, cloth, and transparent face masks on speech signals. J Acoust Soc Am. 2020 Oct;148(4):2371. doi: 10.1121/10.0002279.

Reference Type BACKGROUND
PMID: 33138498 (View on PubMed)

Muzzi E, Chermaz C, Castro V, Zaninoni M, Saksida A, Orzan E. Short report on the effects of SARS-CoV-2 face protective equipment on verbal communication. Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3565-3570. doi: 10.1007/s00405-020-06535-1. Epub 2021 Jan 3.

Reference Type BACKGROUND
PMID: 33389012 (View on PubMed)

Hampton T, Crunkhorn R, Lowe N, Bhat J, Hogg E, Afifi W, De S, Street I, Sharma R, Krishnan M, Clarke R, Dasgupta S, Ratnayake S, Sharma S. The negative impact of wearing personal protective equipment on communication during coronavirus disease 2019. J Laryngol Otol. 2020 Jul;134(7):577-581. doi: 10.1017/S0022215120001437. Epub 2020 Jul 28.

Reference Type BACKGROUND
PMID: 32641175 (View on PubMed)

Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol. 2009 Oct;34(5):447-54. doi: 10.1111/j.1749-4486.2009.01995.x.

Reference Type BACKGROUND
PMID: 19793277 (View on PubMed)

McCoul ED, Anand VK, Christos PJ. Validating the clinical assessment of eustachian tube dysfunction: The Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope. 2012 May;122(5):1137-41. doi: 10.1002/lary.23223. Epub 2012 Feb 28.

Reference Type BACKGROUND
PMID: 22374681 (View on PubMed)

Other Identifiers

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SP0620

Identifier Type: -

Identifier Source: org_study_id

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