The Study on the Preventive Method of the Middle Ear Barotrauma Caused by Hyperbaric Oxygen Therapy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Middle ear barotrauma is a damage of the ear resulting from the pressure difference between the middle ear and the atmospheric environment. We investigated the effects of chewing gum and administering the systemic decongestant in hyperbaric oxygen therapy. MATERIALS AND METHOD: We investigated the cases of the middle ear barotrauma which came from hyperbaric oxygen therapy for finger replantation. We studied 81 patients without E-tube dysfunction. They were divided into three groups: the non-treated patients, the patients chewing gums and receiving high-pressure treatment, and the patients receiving the systemic decongestant. We investigated the patients for symptoms, otoscopic findings, tympanometry, and PTA. Otoscopic findings were classified by modified Teed classification. RESULTS: In the first group, 36 of 60 (60%) ears had otologic symptoms, 37 of 60 (62%) ears were above the grade 1, 31 of 60 (52%) ears were B or C type in tympanometry and 20 of 60 (33%) ears were above 20dB in AB gap (air-bone gap). In the second group, 23 of 60 (38%) ears had the otologic symptom, 26 of 60 (43%) ears were above the grade 1, 19 of 60 (32%) ears were the B or C type and 10 of 60 (17%) ears were above 20dB in AB gap. In the third group, 18 of 42 (43%) ears had the otologic symptoms, 19 of 42 (45%) ears were above the grade 1, 15 of 42 (36%) ears were the B or C type and 7 of 42 (17%) ears were above 20dB in the AB gap. CONCLUSION: The second group was better than the first group with regard to otologic symptom, otoscopic findings, tympanometry, PTA, and showed statistical significance. On the other hand, the third group was effective but did not show statistical significance.

Barotrauma of the Middle Ear in Guinea Pigs after Simulated Diving / 대한이비인후과학회지

To confirm the possibility of middle ear barotrauma in Guinea Pigs even to safe, recomm-endable diving profiles to sports SCUBA divers and to study operating microscopic findings and progress of middle ear barotrauma, 16 Guinea Pigs were exposed to hyperbaric chamber for simulated diving. Simulated diving profiles were 20 meter sea water of maximum depth, 18 meter per minute of ascent, descent rates, 20 minutes of bottom time, 60 minutes of surface interval time and 2 repetitive dives in a day for 2 consecutive days. Then, tympanic membrane, middle ear and round membrane window were examined by operating microscope on 1 day, 7 days after simulated diving respectively. The experimental results showed that 26 of 32 ears(81.2%) disclosed findings of barotrauma in total, 23 ears(71.9%) in tympanic membrane, 25(78.1%) in middle ear, 7 ears(21.9%) in round window membrane respectively. The main operating microscopic findings of barotrauma were hyperemia of tympanic membrane in 23 ears(71.9%), hyperemia in 25 ears(78.1%), bleeding in 22 ears(68.8%) of middle ear, followed by bleeding, perforation of tympanic membrane, edema, effusion in middle ear, bleeding and rupture of round window membrane in order. Hyperemia of tympanic membrane and bleeding of middle ear in day 7 group showed significantly lower rate of barotrauma than those of day 1 group, that suggest spontaneous improvement in mild case of experimental middle ear barotrauma.