{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T10:45:40Z","timestamp":1782470740607,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantitatively evaluate noise exposure during pediatric ear procedures for children with developmental disorders, with a focus on screaming behavior and assess its implications for both patient\u2010centered care and occupational safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study of 66 children who underwent earwax removal at a medical center in Japan. The noise levels were measured using smartphone\u2010based sound\u2010level meters and a calibrated dosimeter. Acoustic parameters (LAeq, LCeq, and LCpeak) were analyzed, and the screaming behavior was classified based on the peak sound pressure levels. Subgroup analyses were performed according to diagnosis, sex, age, and developmental quotient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean LAeq and LCpeak were 78.0\u2009dBA and 114.2\u2009dBC, respectively. LAeq exceeded 85\u2009dBA in 27.7% of cases and exceeded 100\u2009dBA in 93.6% of cases, indicating a risk of acute noise\u2010induced hearing loss. Assistants positioned directly in front of the patients were exposed to significantly higher levels than physicians. Screaming behavior was strongly associated with autism spectrum disorder (odds ratio: 6.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), but not with developmental quotient scores. Spectral analysis revealed elevated sound pressure in the 500\u20134000\u2009Hz range. Furthermore, the cumulative noise dose could exceed the recommended daily limits within minutes, underscoring the acute risk of short\u2010term peaks rather than chronic exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric ear procedures involving children with developmental disorders can generate hazardous noise, particularly during screaming episodes in children with autism spectrum disorder. These findings highlight the dual need to reduce patient distress through sensory\u2010adapted environments and protect healthcare providers from acute acoustic trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2c.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70396","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:25:36Z","timestamp":1778520336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Screaming\u2010Induced Acute Noise Exposure During Pediatric Ear Procedures"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8288-5484","authenticated-orcid":false,"given":"Jun\u2010Ya","family":"Kita","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Hamamatsu University School of Medicine  Hamamatsu Japan"},{"name":"Hamamatsu City Welfare and Medical Center for Development  Shizuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hamamatsu University School of Medicine  Hamamatsu Japan"},{"name":"Department of Otolaryngology, Head and Neck Surgery, School of Medicine Iwate Medical University  Shiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuno","family":"Tamakoshi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Sone","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sosuke","family":"Sahara","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Misawa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckad044"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.22833"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15040813"},{"key":"e_1_2_10_5_1","volume-title":"Understand Noise Exposure","author":"Noise and Hearing Loss Prevention 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