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Initial Severity Scoring and Residual Deficit in Scuba Divers with Inner Ear Decompression Sickness
Emmanuel Gempp1, Pierre Louge, Sébastien de Maistre
1Department of Diving and Hyperbaric Medicine and the Department of Otorhinolaryngology, Head and Neck Surgery, Sainte Anne's Military Hospital, Toulon, France.
Aerospace Medicine and Human Performance
|September 17, 2016
Summary
A high clinical score and delayed recompression are key predictors of poor recovery from inner ear decompression sickness (IEDCS) in scuba divers. Early assessment and prompt treatment are crucial for better outcomes in these diving injuries.
Area of Science:
- Diving Medicine
- Aerospace Medicine
- Neurology
Background:
- Inner ear decompression sickness (IEDCS) in scuba divers can lead to lasting vestibulocochlear impairments.
- These deficits may negatively impact a diver's health-related quality of life.
- Predictive factors for poor clinical recovery and a prognostic score are needed.
Purpose of the Study:
- To identify factors predicting poor clinical recovery from IEDCS.
- To develop a prognostic score based on initial physical examination findings.
- To improve outcomes for scuba divers experiencing IEDCS.
Main Methods:
- Retrospective analysis of medical records for 99 IEDCS patients (2009-2014).
- Clinical severity assessed using a numerical score (vestibular and cochlear symptoms).
- Multivariate analysis of risk factors and prognostic reliability of the score.
Main Results:
- 24% of patients experienced residual symptoms.
- High initial clinical score (OR=1.39) and delayed recompression >6 hours (OR=1.001) independently predicted incomplete recovery.
- The clinical score demonstrated high specificity (92%) but lower sensitivity (48%) for predicting sequelae.
Conclusions:
- IEDCS severity can be reliably assessed with a clinical score during the acute phase.
- Prompt hyperbaric recompression is essential and should not be delayed.
- The findings aid in predicting outcomes and guiding treatment for IEDCS.
