Influence of repetitive diving in saltwater on pressure equalization and Eustachian tube function in recreational scuba divers

Jansen, Stefanie; Boor, Manuela; Meyer, Moritz; Pracht, Eberhard D.; Volland, Ruth; Klünter, Heinz Dieter; Hüttenbrink, Karl-Bernd; Beutner, Dirk; Grosheva, Maria

doi:10.28920/dhm47.4.216-222

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…This symptom mainly aff ected people with allergic rhinitis or acute rhinitis [15]. In contrast, Jansen et al showed signifi cantly higher middle ear peak pressures and higher pressure diff erences after equilibration maneuvers in people with exposure of the Eustachian tube to increased atmospheric pressure [6,13]. Therefore, any patient who reports the symptom of a "plugged ear" should have a tympanometry test.…”

Section: Discussionmentioning

confidence: 99%

“…Patients operated on for hypertrophic lesions of the inferior nasal turbinates usually report from the fi rst day, apart from pain, obstruction of the nasal cavity and a feeling of "plugged ears" [7,9,10,13]. Pain most often subsides after a few hours, nasal obstruction usually resolves between 5 and 7 days after surgery, while the feeling of "plugged ears" can persist much longer [5,8,10,21,23,29].…”

Section: Introductionmentioning

confidence: 99%

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2023

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Chronic hypertrophic rhinitis is one of the most common diseases in rhinology. Various surgical techniques are used to reduce hypertrophic changes in the inferior turbinates.The aim of our study is to determine the impact of plastic surgery of the lower nasal turbinates, performed by cryoablation or radiocoblation, on the patency of the Eustachian tube and to determine how long the waiting period should be for activities that particularly require patent ear tubes, such as traveling by plane.A total of 70 patients treated at the Department of Otolaryngology of the Military Institute of Aviation Medicine were qualifi ed for the study. Due to the technique of conchoplasty of the lower nasal turbinates, the patients were divided into two groups. Group I consisted of 35 patients, including 15 women and 20 men, aged 24 to 62 (mean 42.67 years), operated on by cryoablation. Group II also comprised 35 patients, including 12 women and 23 men, aged 29 to 69 (mean 44.21 years), operated on by radiocoblation.Plastic surgeries of the lower nasal turbinates, also known as conchoplasties, were performed under local anesthesia with a cryosurgery machine with the use of a nasal applicator and an apparatus for submucosal coblation with the use of radio waves. The patency of the Eustachian tube was assessed by tympanometry before the operation and 1, 2 and 3 weeks after the operation.

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confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“…ETOD defines the time span between opening and closing of the ET. Evaluation of the ET parameters in detail are demonstrated in previously published articles [8,9,12,13].…”

Section: Eustachian Tube Function Parametermentioning

confidence: 99%

Prospective study on the Eustachian tube function during Frenzel maneuver in a hypobaric/hyperbaric pressure chamber

Wolber

Meyer

Knesic

et al. 2021

Eur Arch Otorhinolaryngol

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Introduction The Frenzel maneuver describes a technique for middle ear equalizing which is frequently used by apnea divers. It offers advantages compared to the most commonly used techniques such as the Valsalva or Toynbee maneuver. Until now, there is insufficient literature about the pressure dynamics and Eustachian tube (ET) function during the Frenzel maneuver. The aim of the present study was to characterize the ET function during the Frenzel maneuver. Materials and methods By means of an established standardized profile of compression and decompression in a hypo/hyperbaric pressure chamber, we examined different parameters such as the ET opening pressure (ETOP), ET opening duration (ETOD), and ET opening frequency (ETOF) in 11 experienced apnea divers and compared them to the parameters during the Valsalva and Toynbee maneuver. Results Standard values for ETOP, ETOD, and ETOF could be established for the Frenzel maneuver under standardized conditions in a hypo/hyperbaric pressure chamber. Compared to the Frenzel maneuver, ETOP was higher and ETOD longer (both p < 0.001) during the Valsalva maneuver whereas ETOP was lower and ETOD shorter (both p < 0.001) during the Toynbee maneuver. No difference regarding ETOF was observed between the Frenzel, Valsalva, and Toynbee maneuver. Discussion The Frenzel maneuver was shown to be at least as effective as the Valsalva maneuver concerning ET opening. We believe that knowledge of the Frenzel technique might facilitate the pressure equalization during diving and recommend implementation of an appropriate equalization training in apnea and scuba diving education.

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Influence of repetitive diving in freshwater on pressure equalization and Eustachian tube function in recreational scuba divers

Jansen¹,

Boor²,

Meyer³

et al. 2017

Diving Hyperb Med

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Introduction: We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). Methods: This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp). The peak pressure difference between the R-tymp and the V-tymp (R-VdP) defined effectiveness of pressure equalization after Valsalva manoeuvres. We evaluated the change in compliance and peak pressure and correlated the results to the otoscopic findings and diving experience. Results: Twenty-three divers performed 144 dives. Middle ear barotrauma was assessed using the Edmonds modification of the TEED scoring system. In the ETFT, the R-tymp peak pressure displayed a negative shift from day one to three (P = 0.001) and differed significantly between the experience groups (P = 0.01). R-VdP did not change significantly on any of the three days of diving (all P > 0.05). Participants without MEBt showed significantly lower R-tymp values than did those with barotrauma (P = 0.019). Conclusion: Repetitive pressure exposure during three consecutive days of freshwater diving led to a negative shift of the peak pressure in the middle ear. Less experienced divers showed significantly higher middle ear peak pressure and higher pressure differences after equalization manoeuvres. Higher middle ear peak pressure was also associated with a higher prevalence of barotrauma.

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Influence of repetitive diving in saltwater on pressure equalization and Eustachian tube function in recreational scuba divers

Abstract: To promote and facilitate the study of all aspects of underwater and hyperbaric medicine To provide information on underwater and hyperbaric medicine To publish a journal and to convene members of each Society annually at a scientific conference OFFICE HOLDERS

Cited by 5 publications

References 19 publications

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Prospective study on the Eustachian tube function during Frenzel maneuver in a hypobaric/hyperbaric pressure chamber

Influence of repetitive diving in freshwater on pressure equalization and Eustachian tube function in recreational scuba divers

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