title: Use of the nine-step inflation/deflation test and resting middle-ear pressure range as predictors of middle-ear barotrauma in aircrew members.
abstract: OBJECTIVE
  To explore the role of the nine-step inflation/deflation tympanometric test and resting middle-ear pressure range as predictors of barotrauma in aircrew members.
  
  
  METHODS
  A prospective, non-randomised study was conducted on 100 aircrew members. Resting middle-ear pressure was measured and the nine-step inflation/deflation test performed on all subjects before flights. Subjects were allocated to two groups according to resting middle-ear pressure range (group A, within the range of +26 to +100 and -26 to -100 mmH2O; group B, -25 to +25 mmH2O). All aircrew members were assessed after flights regarding the presence and the grade of barotrauma.
  
  
  RESULTS
  In both groups, the sensitivity and specificity values of the entire post-inflation/deflation test were close to those of the post-deflation part of the test. The post-deflation test had a higher negative predictive value than the post-inflation test. Ears with resting middle-ear pressure lower than -55 mmH2O experienced barotrauma, regardless of good or poor post-inflation or post-deflation test results.
  
  
  CONCLUSIONS
  In an aircrew member, a resting middle-ear pressure within the range of -55 and +50 mmH2O, together with good post-deflation test results, are considered reliable predictors for fitness to fly.
authors.affiliation: Department of Otorhinolaryngology,Cairo University,Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Hussein
authors.affiliation: Department of Otorhinolaryngology,Suez Canal University,Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Abousetta
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods*; D000328:Adult; D000401:Aircraft; D001469:Barotrauma / Q000175:diagnosis* / Q000503:physiopathology; D004432:Ear, Middle / Q000293:injuries* / Q000503:physiopathology; D005064:Eustachian Tube / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D015203:Reproducibility of Results