title: Peripheral neuropathy may increase the risk for asymptomatic otic barotrauma during hyperbaric oxygen therapy: research report.
abstract: OBJECTIVE
  Otic barotrauma (OBT) is an adverse event seen in patients receiving hyperbaric oxygen (HBO2) therapy. After encountering a case of painless tympanic perforation during HBO2 therapy of a diabetic patient with the diagnosis of neuropathic Wagner Grade III foot ulcer, we hypothesized that peripheral neuropathy of the lower extremity may be associated with an increased risk of asymptomatic OBT during HBO2 therapy.
  
  
  METHODS
  The medical records of all HBO2 patients during a one-year period of time were reviewed. Subjects were selected based on otoscopic documentation of OBT and divided into two groups based on the presence or absence of lower extremity peripheral neuropathy. Time to therapeutic compression, presence or absence of ear-related symptoms and modified Teed (mTeed) scores were compared between the two groups.
  
  
  RESULTS
  A total of 38 patients with OBT, 18 neuropathic and 20 non-neuropathic, were identified. Asymptomatic OBT occurred more frequently in the neuropathic vs. non-neuropathic group (56% vs. 5%, p < 0.001). mTeed scores were significantly greater in the neuropathic vs. non-neuropathic group (mTeed 1, 30% vs. 61%; mTeed 2, 65% vs. 36%; mTeed 3, 4% vs. 3%; p = 0.032). Mean compression times were shorter in the neuropathic vs. non-neuropathic group (10. 5 +/- 1.8 vs. 14.4 +/- 3.3 minutes, p < 0.001).
  
  
  CONCLUSIONS
  The presence of peripheral neuropathy of the lower extremity may be associated with a significantly greater incidence of asymptomatic otic barotrauma during HBO2 therapy.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mozdzanowski
authors.forename: George A
authors.initials: GA
authors.lastname: Perdrizet
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology; D001469:Barotrauma / Q000453:epidemiology / Q000209:etiology*; D003929:Diabetic Neuropathies / Q000150:complications*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects*; D015994:Incidence; D008875:Middle Aged; D058028:Research Report; D012189:Retrospective Studies; D018058:Tympanic Membrane Perforation / Q000453:epidemiology / Q000209:etiology*