title: [The predictive value of assessing mastoid pneumatization in pre-dive examinations].
abstract: 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.
authors.affiliation: Department of Otolaryngology, Medicine Faculty of Trakya University, Edirne, Turkey. cemuzun@yahoo.com
authors.forename: Cem
authors.initials: C
authors.lastname: Uzun
authors.forename: Abdullah
authors.initials: A
authors.lastname: Taş
authors.forename: Recep
authors.initials: R
authors.lastname: Yağiz
authors.forename: Mustafa K
authors.initials: MK
authors.lastname: Adali
authors.forename: Muhsin
authors.initials: M
authors.lastname: Koten
authors.forename: Haldun
authors.initials: H
authors.lastname: San
authors.forename: Ahmet R
authors.initials: AR
authors.lastname: Karasalihoğlu
mesh_terms: 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