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Inner ear barotrauma and inner ear decompression sickness: a systematic review on differential diagnostics.
Oskari H Lindfors1,2, Anne K Räisänen-Sokolowski3,4, Timo P Hirvonen1
1Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Diving and Hyperbaric Medicine
|December 13, 2021
Summary
Inner ear barotrauma and inner ear decompression sickness are diving injuries with similar symptoms. Differentiating them involves analyzing dive type, gas, depth, and symptom timing.
Area of Science:
- Diving Medicine
- Otolaryngology
- Emergency Medicine
Background:
- Inner ear barotrauma (IEBt) and inner ear decompression sickness (IEDCS) are dysbaric inner ear injuries from diving.
- Both conditions present with overlapping cochleovestibular symptoms, complicating diagnosis and treatment.
Purpose of the Study:
- To systematically review and identify key variables differentiating IEBt from IEDCS.
- To improve diagnostic accuracy and guide appropriate treatment for these diving-related ear injuries.
Main Methods:
- Systematic review of published English-language studies reporting IEBt or IEDCS cases.
- Searched PubMed, Medline, and Scopus databases.
- Contacted original authors to clarify data and minimize missing or duplicate information.
Main Results:
- Analyzed 25 studies (183 IEBt patients) and 18 studies (397 IEDCS patients).
- Key differentiating variables include dive type, gas, depth, symptom onset (descent vs. ascent), and symptom distribution (vestibular vs. cochlear).
- Middle ear barotrauma symptoms were inconsistently reported in IEDCS cases.
Conclusions:
- Multiple clinical and diving variables effectively distinguish IEBt from IEDCS.
- Further research is needed on middle ear barotrauma symptoms for improved differentiation.
