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Middle ear barotrauma in patients undergoing hyperbaric oxygen therapy
J Blanshard1, A Toma, P Bryson
1Department of Otolaryngology, Derriford Hospital, Plymouth, UK.
Clinical Otolaryngology and Allied Sciences
|October 1, 1996
Summary
Hyperbaric oxygen therapy can cause middle ear barotrauma. Despite preventative measures, up to 8% of ears may experience significant injury, with otoscopy being the most reliable screening method.
Area of Science:
- Otolaryngology
- Diving Medicine
- Aerospace Medicine
Background:
- Hyperbaric oxygen therapy (HBOT) carries a risk of barotrauma, particularly affecting the middle ear.
- Chronic conditions often necessitate long-term HBOT, increasing exposure duration and potential complications.
Purpose of the Study:
- To prospectively evaluate the incidence and severity of middle ear barotrauma in patients undergoing long-term HBOT.
- To assess the effectiveness of preventative measures and diagnostic tools for HBOT-induced otic complications.
Main Methods:
- Prospective study involving 82 patients receiving long-term HBOT.
- Data collection included patient-reported otalgia, need for ventilation tubes, otoscopic examination, and tympanometry.
- Severity grading of barotrauma used the TEED scale.
Main Results:
- 29.3% of patients required ventilation tubes for otalgia, with a higher incidence in those with head and neck radionecrosis (P < 0.01).
- Of 58 assessed patients, 8% showed otoscopic evidence of significant barotrauma (TEED grade 3 or 4).
- Tympanometry identified middle ear effusion in only 2% of ears, indicating lower sensitivity.
Conclusions:
- Significant middle ear barotrauma can occur in up to 8% of ears despite patient education and ventilation tube use.
- Otoscopy is a more reliable screening tool for detecting HBOT-induced middle ear barotrauma than tympanometry.