Otic barotrauma: Difference between revisions
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==Background== | ==Background== | ||
*Also known as "ear squeeze" during scuba diving or air | *Also known as "ear squeeze" - generally seen during scuba diving or air travel | ||
==Clinical Features== | ==Clinical Features== | ||
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====Inner Ear==== | ====Inner Ear==== | ||
*Results from forceful | *Results from forceful valsalva against an occluded eustachian tube | ||
**Pressure difference between middle ear and inner ear can rupture oval or round window | **Pressure difference between middle ear and inner ear can rupture oval or round window | ||
*Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo | *Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo | ||
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==Evaluation== | ==Evaluation== | ||
* | *Generally clinical | ||
==Management== | ==Management== | ||
====Middle Ear==== | ====Middle Ear==== | ||
* | *Decongestants | ||
* | *Consider [[antibiotics]] if [[typmanic membrane ruptured]] | ||
====Inner Ear==== | ====Inner Ear==== | ||
* | *Elevate head of bed | ||
* | *Advise patient to not blow nose | ||
* | *Antivertigo medications | ||
*ENT consult | *ENT consult | ||
==Disposition== | ==Disposition== | ||
* | *Generally may be discharged | ||
==See Also== | ==See Also== | ||
Revision as of 00:31, 1 January 2017
Background
- Also known as "ear squeeze" - generally seen during scuba diving or air travel
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
Ear Diagnoses
External
- Auricular hematoma
- Auricular perichondritis
- Cholesteatoma
- Contact dermatitis
- Ear foreign body
- Herpes zoster oticus (Ramsay Hunt syndrome)
- Malignant otitis externa
- Otitis externa
- Otomycosis
- Tympanic membrane rupture
Internal
- Acute otitis media
- Chronic otitis media
- Mastoiditis
Inner/vestibular
Barotrauma Types
- Otic barotrauma
- Pulmonary barotrauma
- Sinus barotrauma
- Mask squeeze
- Barodentalgia (trapped dental air causing squeeze)
Evaluation
- Generally clinical
Management
Middle Ear
- Decongestants
- Consider antibiotics if typmanic membrane ruptured
Inner Ear
- Elevate head of bed
- Advise patient to not blow nose
- Antivertigo medications
- ENT consult
Disposition
- Generally may be discharged