title: Otological complications associated with hyperbaric oxygen therapy.
abstract: The objective of the present study was to clarify the features of otological complications for hyperbaric oxygen therapy (HBOT) and the risk factors for these complications. We enrolled 1115 patients (776 males and 339 females; age 5-89 years) who underwent HBOT. All otological symptoms experienced during HBOT sessions were evaluated, and risk factors were analysed using multivariate logistic regression analysis. Otoscopic findings and interventions for otological complications were assessed in 58 symptomatic patients who visited the Otolaryngology Department. Otological symptoms were experienced by 165 (14.8 %) of the 1115 patients. The multivariate logistic regression analysis identified ages of >60 years and female sex as independent risk factors, whereas patients with sports injuries were at lower risk than those with other primary diseases, except for severe infectious disease. Eighty-two patients (49.7 %) suffered from symptoms at the first HBOT session. The most prevalent symptoms were otalgia (157/165), followed by ear fullness (13/165), hearing loss (12/165) and tinnitus (3/165). One patient experienced vertigo and deterioration of the bone-conduction pure-tone thresholds, suggesting inner ear barotrauma. In 116 ears of the 58 symptomatic patients, abnormal otoscopic findings were recognized in 58 ears (50.0 %). Twenty-seven of the 58 ears required myringotomy or tube insertion, and HBOT was stopped in eight ears in four patients. Of the remaining 58 ears with normal otoscopic findings, 51 received no treatment. Physicians should be aware of both middle and inner ear barotrauma as potential complications of HBOT.
authors.affiliation: Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan. noguchi.oto@gmail.com.|Department of Hearing Implant Sciences, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan. noguchi.oto@gmail.com.
authors.forename: Yoshihiro
authors.identifier: http://orcid.org/0000-0003-4046-0741
authors.initials: Y
authors.lastname: Noguchi
authors.affiliation: Hyperbaric Medical Center, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Enomoto
authors.affiliation: Hyperbaric Medical Center, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yagishita
authors.affiliation: Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kitamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004427:Ear Diseases / Q000209:etiology*; D004433:Earache / Q000209:etiology; D005260:Female; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data; D038781:Otoscopy; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014012:Tinnitus / Q000209:etiology; D014717:Vertigo / Q000209:etiology; D055815:Young Adult
keywords: Barotrauma; Complication; Ear; Hyperbaric oxygen therapy; Multivariate logistic regression analysis; Vertigo