[The predictive value of assessing mastoid pneumatization in pre-dive examinations].
OBJECTIVE
We investigated the value of assessing the degree of mastoid pneumatization in predicting middle ear barotrauma -the most common problem in sport SCUBA divers- in comparison with that of the conventional pre-dive examination method, the Valsalva maneuver.


METHODS
Thirty-four volunteer sport SCUBA divers having normal pre-dive examination findings were included. The Valsalva test was performed in all the divers. Mastoid pneumatization for each ear was calculated on a Schuller's view radiography. Pneumatization of = or <30 cm2 was accepted as poor (prone to barotrauma) and >30 cm2 was accepted as good (not prone to barotrauma). During the observation period, the divers were monitored with regard to barotrauma symptoms and signs.


RESULTS
The degree of mastoid pneumatization was = or <30 cm2 in 26 ears (38%) of 16 divers (47%). The Valsalva test was negative in eight ears (12%) of six divers (18%). During a total of 1001 dives, symptomatic middle ear barotrauma occurred in 28 dives (2.8%), i.e. in 21 ears (31%) of 16 divers (47%). Of these, the degree of mastoid pneumatization predicted barotrauma in 11 (69%) divers, whereas the Valsalva test was negative in only three (19%) (p<0.05), with sensitivity, specificity, positive and negative predictive values, and efficiency being 69% and 19%, 72% and 83%, 69% and 50%, 72% and 54%, and 71% and 53%, respectively.


CONCLUSIONS
The value of assessing mastoid pneumatization in predicting middle ear barotrauma in sport SCUBA divers is higher than that of the Valsalva test.
Uzun
Cem
C
Department of Otolaryngology, Medicine Faculty of Trakya University, Edirne, Turkey. cemuzun@yahoo.com
Taş
Abdullah
A
Yağiz
Recep
R
Adali
Mustafa K
MK
Koten
Muhsin
M
San
Haldun
H
Karasalihoğlu
Ahmet R
AR
D000293:Adolescent; D000328:Adult; D001469:Barotrauma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000517:prevention & control; D004242:Diving / Q000009:adverse effects*; D004432:Ear, Middle / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000502:physiology*; D011237:Predictive Value of Tests; D011859:Radiography; D014636:Valsalva Maneuver