title: Middle-ear barotrauma after hyperbaric oxygen therapy.
abstract: BACKGROUND
  Middle-ear barotrauma (MEB) is one of the most common side effects of hyperbaric oxygen therapy (HBO2). The incidence of MEB has been shown to vary between treatment centers and patients. This study was aimed to determine which patients are at high risk of MEB.
  
  
  METHODS
  Prospective study including all the patients treated in a multiplace HBO2 chamber between January and December 2005. Scoring of MEB before and after HBO2 by otoscopy was performed using the Haines and Harris classification.
  
  
  RESULTS
  We included 130 patients: 53 Males, 37.5 +/- 20.5 years old; 76% were treated for CO poisoning, 11% for iatrogenic gas embolism, 12% for decompression sickness and 4% for necrotizing soft tissue infection. 13% were intubated. MEB occurred in 13.6% of the patients (12.4% of the conscious and 24.4% of the intubated patients, p = 0.26). Risk factors for MEB were: repetitive treatments and difficulties with pressure equalization. There was no influence of age, sex or mechanical ventilation on the occurrence of MEB.
  
  
  CONCLUSIONS
  MEB induced by HBO2 occurred in 13.6% of the patients. There is no difference in incidence when comparing intubated and non-intubated patients. In non-comatose patients, difficulties with equalizing pressure were predictive of MEB.
authors.affiliation: Hyperbaric Medicine Centre, Pôle RUSH, Sainte-Marguerite Hospital, Marseille, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Bessereau
authors.forename: Alexis
authors.initials: A
authors.lastname: Tabah
authors.forename: Nicolas
authors.initials: N
authors.lastname: Genotelle
authors.forename: Adrien
authors.initials: A
authors.lastname: Français
authors.forename: Mathieu
authors.initials: M
authors.lastname: Coulange
authors.forename: Djillali
authors.initials: D
authors.lastname: Annane
mesh_terms: D000328:Adult; D001469:Barotrauma / Q000453:epidemiology / Q000209:etiology*; D002249:Carbon Monoxide Poisoning / Q000628:therapy; D016009:Chi-Square Distribution; D003665:Decompression Sickness / Q000628:therapy; D004432:Ear, Middle / Q000293:injuries*; D004618:Embolism, Air / Q000628:therapy; D005260:Female; D005602:France; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects*; D008297:Male; D009336:Necrosis / Q000628:therapy; D011446:Prospective Studies; D018461:Soft Tissue Infections / Q000628:therapy; D018709:Statistics, Nonparametric