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Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement
F W Fiesseler1, M E Silverman, R L Riggs
1Department of Emergency Medicine, Morristown Memorial Hospital, Morristown, New Jersey, USA.
Introduction:
Hyperbaric oxygen therapy (HBO2) has been utilized for many years for a multitude of disease entities. One commonly encountered side-effect is otic barotrauma.
Objective:
To determine if patients with specific disease processes are at increased risk of requiring tympanostomy tubes during HBO2.
Methods:
Data was obtained from Jan. 2000 to Dec. 2004, retrospectively. The requirement for tympanostomy tubes during a course of HBO2 was established.
Results:
325 met inclusion criteria. Fifteen percent of patients overall (95% CI= 11-19%) required tympanostomy tubes. Tubes were required in: 5% necrotizing soft tissue infection (p=0.33); 10% failed/threatened graft (p=0.39); 15% problem wounds; 17% chronic refractory osteomyelitis (CRO) (p=0.64); 22% soft tissue radionecrosis (STRN)/osteoradionecrosis (ORN) (p=0.02); 33% of crush injuries (p=0.10). Twenty-nine percent of nasopharyngeal radiation injury patients (p=0.001) and 10% of the non-nasopharyngeal radiation patients (p=0.36) received tympanostomy tubes.
Conclusion:
A significant increase in tympanostomy tubes were required in nasopharyngeal radiation injury patients.
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