title: Middle ear barotrauma in patients undergoing hyperbaric oxygen therapy.
abstract: Hyperbaric oxygen therapy is associated with a risk of barotrauma to the middle ear. This prospective study of 82 patients undergoing long-term therapy for chronic conditions was designed to measure the incidence and severity of middle ear barotrauma. Twenty-four patients (29.3%) required the insertion of ventilation tubes for otalgia, significantly more of whom were suffering from radionecrosis of the head and neck region (P < 0.01). Thirty-two of the remaining 58 patients (55%) underwent specialist ENT assessment by otoscopy and tympanometry. Five ears (8%) showed the otoscopic changes of barotrauma (TEED grade 3 or 4), and one ear (2%) showed tympanometric evidence of a middle ear effusion (Type B tympanogram). We conclude that despite careful tuition in pressure equalization and the appropriate use of ventilation tubes, up to 8% of ears sustain significant barotrauma. Tympanometry is unreliable in detecting these changes, otoscopy provides the most reliable screening technique.
authors.affiliation: Department of Otolaryngology, Derriford Hospital, Plymouth, UK.
authors.forename: J
authors.initials: J
authors.lastname: Blanshard
authors.forename: A
authors.initials: A
authors.lastname: Toma
authors.forename: P
authors.initials: P
authors.lastname: Bryson
authors.forename: P
authors.initials: P
authors.lastname: Williamson
mesh_terms: D000368:Aged; D001469:Barotrauma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D004432:Ear, Middle / Q000293:injuries*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation; D011446:Prospective Studies