Otic barotrauma: Difference between revisions
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====Middle Ear==== | ====Middle Ear==== | ||
*decongestants | *decongestants | ||
*consider | *consider [[antibiotics]] if [[typmanic membrane ruptured]] | ||
====Inner Ear==== | ====Inner Ear==== | ||
Revision as of 18:52, 1 March 2015
Background
- Also known as "ear squeeze" during scuba diving or air flight
Clinical Features
Middle Ear
- Results from inability to equalize middle ear pressure
- Pain, fullness, vertigo, conductive hearing loss, TM rupture
Inner Ear
- Results from forceful Valsalva against an occluded eustachian tube
- Pressure difference between middle ear and inner ear can rupture oval or round window
- Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo
Differential Diagnosis
Diving Emergencies
- Barotrauma of descent
- Otic barotrauma
- Pulmonary barotrauma
- Sinus barotrauma
- Mask squeeze
- Barodentalgia (trapped dental air causing squeeze)
- Barotrauma of ascent
- Pulmonary barotrauma (pulmonary overpressurization syndrome)
- Decompression sickness (DCS)
- Arterial gas embolism
- Alternobaric vertigo
- Facial baroparesis (Bells Palsy)
- At depth injuries
- Oxygen toxicity
- Nitrogen narcosis
- Hypothermia
- Contaminated gas mixture (e.g. CO toxicity)
- Caustic cocktail from rebreathing circuit
Workup
Management
Middle Ear
- decongestants
- consider antibiotics if typmanic membrane ruptured
Inner Ear
- Head of bed up
- no nose blowing
- antivertigo medications
- ENT consult