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Interesting study on Eustachian tube function in a scuba-related barotrauma.
Appears to be a bit of a rough translation from the Japanese, but I believe that one take-away for board members is to use a non-pressurized equalization technique (e.g., Toynbee, Rodyhouse, Beance Tubaire Volontaire (BTV)) rather than a pressurized maneuver (e.g., Valsalva) if you can.
"Nihon Jibiinkoka Gakkai Kaiho. 2012 Dec;115(12):1029-36.
[A study of the Eustachian tube function in patients with a scuba diving accident].
[Article in Japanese]
Kitajima N, Sugita-Kitajima A, Kitajima S.
SourceKitajima ENT Clinic
Abstract
The scuba diving population has increased very much recently, bringing with it a rise in barotrauma. Ninety-seven patients with scuba diving-related accidents (34 males and 63 females; mean +/- SD: 36.6 +/- 10.3 years) and 39 healthy volunteers (9 males and 30 females; mean +/- SD: 41.1 +/- 16.9 years) without a history of Eustachian tube dysfunction participated in this study. All patients underwent audiometric measurements, including hearing testing, tympanometry, and Eustachian tube function testing (sonotubometry and impedance test). The tympanometry results of the majority of the patients were normal (Jerger A type), however, 83 of 97 patients (85.6%) were diagnosed as having Eustachian tube dysfunction: all patients had tubal stenosis. Compared with healthy volunteers, the Eustachian tube function in scuba diving patients was significantly lower. According to whether the affected parts were one ear or both ears, we classified these patients into 2 types, that is, the unilateral group and the bilateral group. The symptoms in the unilateral group were more serious than those in the bilateral group. In the unilateral group, the Eustachian tube functions of the affected ear did not always show lower than those of the healthy ear, so we thought that excessive positive pressure at the mesotympanum caused by the Valsalva maneuver might have affected not only the affected ear but also the healthy ear and have resulted in healthy ears being severely impaired by excessive positive pressure. To prevent scuba divers from pressure injury, we think that divers should have their Eustachian tube dysfunction accurately evaluated and any problems should be treated well."
Cheers,
DocVikingo
Appears to be a bit of a rough translation from the Japanese, but I believe that one take-away for board members is to use a non-pressurized equalization technique (e.g., Toynbee, Rodyhouse, Beance Tubaire Volontaire (BTV)) rather than a pressurized maneuver (e.g., Valsalva) if you can.
"Nihon Jibiinkoka Gakkai Kaiho. 2012 Dec;115(12):1029-36.
[A study of the Eustachian tube function in patients with a scuba diving accident].
[Article in Japanese]
Kitajima N, Sugita-Kitajima A, Kitajima S.
SourceKitajima ENT Clinic
Abstract
The scuba diving population has increased very much recently, bringing with it a rise in barotrauma. Ninety-seven patients with scuba diving-related accidents (34 males and 63 females; mean +/- SD: 36.6 +/- 10.3 years) and 39 healthy volunteers (9 males and 30 females; mean +/- SD: 41.1 +/- 16.9 years) without a history of Eustachian tube dysfunction participated in this study. All patients underwent audiometric measurements, including hearing testing, tympanometry, and Eustachian tube function testing (sonotubometry and impedance test). The tympanometry results of the majority of the patients were normal (Jerger A type), however, 83 of 97 patients (85.6%) were diagnosed as having Eustachian tube dysfunction: all patients had tubal stenosis. Compared with healthy volunteers, the Eustachian tube function in scuba diving patients was significantly lower. According to whether the affected parts were one ear or both ears, we classified these patients into 2 types, that is, the unilateral group and the bilateral group. The symptoms in the unilateral group were more serious than those in the bilateral group. In the unilateral group, the Eustachian tube functions of the affected ear did not always show lower than those of the healthy ear, so we thought that excessive positive pressure at the mesotympanum caused by the Valsalva maneuver might have affected not only the affected ear but also the healthy ear and have resulted in healthy ears being severely impaired by excessive positive pressure. To prevent scuba divers from pressure injury, we think that divers should have their Eustachian tube dysfunction accurately evaluated and any problems should be treated well."
Cheers,
DocVikingo