title: Ear pain and its treatment in hypobaric chamber training in the Japan Air Self-Defense Force.
abstract: BACKGROUND
  We have documented that ear pain is the most prevalent physiologic incident during hypobaric chamber training in the Japan Air Self-Defense Force. Ear pain may increase also in flight in the future because it is closely related to allergic rhinitis. Therefore, it is very important to know the characteristic of ear pain and the efficacy of its treatment.
  
  
  METHODS
  The incidence of ear pain was calculated in each training profile from 1990 to 1998. Type III chamber flight records were further analyzed for the characteristics of ear pain: relationship with a trainee occupational category, time of occurrence of ear pain, and efficacy of treatment.
  
  
  RESULTS
  Of 17,935 exposures, 740 trainees (4.1%) had ear pain. Of 7,047 trainees, 429 (6.1%) complained of ear pain especially in Type III, totaling 625 times. Fighter pilots and cargo pilots complained of ear pain one twelfth and one third the number of times, respectively, compared with passengers. Of the 625 episodes, 616 (98.6%) occurred during descent. Three kinds of treatment were administered until the pain was relieved in the following order: Valsalva maneuver, Politzer bag, and decompression. The efficacy rates were 35.8, 92.3, and 83.9%, respectively. Only 5 trainees (0.07%) could not complete training due to ear pain despite treatment.
  
  
  CONCLUSIONS
  The combination treatment of Valsalva maneuver, Politzer bag, and decompression is very effective for relieving ear pain encountered during hypobaric chamber training. A health specialist needs to understand ear pain and its treatment in hypobaric environment such as aircraft.
authors.affiliation: Aeromedical Laboratory, Japan Air Self-Defense Force, Tachikawa, Tokyo, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohrui
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.forename: Andrew
authors.initials: A
authors.lastname: Tong
authors.forename: Masashi
authors.initials: M
authors.lastname: Iwata
mesh_terms: D000328:Adult; D001273:Atmosphere Exposure Chambers / Q000009:adverse effects*; D001359:Aviation / Q000193:education*; D003664:Decompression; D004427:Ear Diseases / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008889:Military Personnel; D016273:Occupational Exposure; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D012121:Respiration, Artificial; D014636:Valsalva Maneuver