Otic Barotrauma Resulting from Continuous Positive Airway Pressure: Case Report and Literature Review.
BACKGROUND
Obstructive sleep apnea (OSA) is a growing problem affecting millions of people in the United States. The prevalence of OSA has risen drastically in the past few decades concurrently with the increasing prevalence of obesity. Subsequently, there has been an ever-increasing rise in the use of continuous positive airway pressure (CPAP) devices. While using CPAP devices may lead to many adverse effects, the majority of these effects are described as relatively benign.


METHODS
We describe the detailed clinical course and outcome for a patient with otic barotrauma as a result of excessive self-titration of CPAP therapy in an in-home setting. We also discuss the pathophysiology of otic barotrauma and present a review of current literature on the topic.


CONCLUSIONS
While the benefits of CPAP are clear, we must take into account the rare but possible effects on ear structure and function. Many studies describe an increase in middle ear pressure with the use of CPAP, but few describe the effects of this increased pressure on the middle ear, such as the otic barotrauma described in this case. Given the increased prevalence of OSA, it is important to understand the risks associated with CPAP therapy.
Department of Otolaryngology - Head and Neck Surgery, University of South Alabama College of Medicine, Mobile, AL.
Justin P
JP
McCormick
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
Douglas M
DM
Hildrew
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
Claire M
CM
Lawlor
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
Jesse A
JA
Guittard
Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.
N Knight
NK
Worley
Barotrauma; cochlear aqueduct; continuous positive airway pressure; ear–middle; eustachian tube; hearing loss; hearing loss–sensorineural; hearing loss–sudden; sleep apnea–obstructive