Decibel Decisions: The Concept of Intracranial Aneurysm Surgery With a Decibel Meter on Two Surgical Cases

The present cases were used to investigate the reliability of the intraoperative decibel meter as an objective method of clipping efficiency in cerebral aneurysm surgery and to assess the impact of this method on the surgical procedure itself. Different methodologies have been developed and applied to directly or indirectly evaluate the placement of a clip, for example, intraoperative digital subtraction angiography (DSA), intraoperative micro-Doppler ultrasonography, and, more recently, indocyanine green (ICG). We included two patients with a previously non-treated unruptured brain aneurysm. In both patients, intraoperative micro-Doppler was used in combination with a decibel meter app. Here, we present the cases of two patients. In patient one, the pre-clipping average sound level/equivalent continuous sound pressure level (Avg/Leq) was 96.7 dB, while the post-clipping Avg/Leq was 94.4 dB, indicating a reduction in sound level after clipping. Similarly, the pre-clipping time-weighted average noise level (TWA) was 1.2%, while the post clipping TWA was 0.5%, indicating a decrease in exposure dose after clipping. In patient two, the average sound level for the post-clipping measurement (94.2 dB) was higher than the pre-clipping measurement (93.5 dB), but the difference was not statistically significant. These cases indicate the potential for using sound measurements as a reliable indicator of adequate aneurysm occlusion during clipping procedures. Further research is needed to confirm these findings.