Does the slow compression technique of hyperbaric oxygen therapy decrease the incidence of middle-ear barotrauma?

Vahidova, D; Sen, P.; Papesch, Michael; Zein‐Sanchez, M. P.; Mueller, Phj

doi:10.1017/s002221510600079x

Cited by 14 publications

(12 citation statements)

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“…Vahidova et al 3 reported 30.9% of smoking in their sample, but did not correlate this with MEB. Uzun 14 , in a study of MEB in divers, found no association between smoking and MEB.…”

Section: Clinical Historymentioning

confidence: 69%

“…HBOT is not without risks and the middle ear barotrauma (MEB) is its most common side effect 3,4 . MEB consists in the appearance of lesions on the tympanic membrane (TM) and/or tympanic cavity, secondary to pressure variation unable to be compensated by the Eustachian tube (ET).…”

Section: Introductionmentioning

confidence: 99%

“…Its incidence ranges from 8 to 68.7% and achieves up to 91% in patients unable to auto-inflate their middle ear (ME) 5 . Symptoms range from discomfort, ear pain, ear fullness, hearing loss, tinnitus and even otorrhagia 2,3,6 . There are conflicting opinions regarding the role of the Eustachian tube (ET) in the occurrence of MEB 7 .…”

Section: Introductionmentioning

confidence: 99%

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Middle ear barotrauma after hyperbaric oxygen therapy - the role of insuflation maneuvers

Lima¹,

Farage²,

Cury³

et al. 2012

The International Tinnitus Journal

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“…Vahidova et al 3 reported 30.9% of smoking in their sample, but did not correlate this with MEB. Uzun 14 , in a study of MEB in divers, found no association between smoking and MEB.…”

Section: Clinical Historymentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Middle ear barotrauma after hyperbaric oxygen therapy - the role of insuflation maneuvers

Lima¹,

Farage²,

Cury³

et al. 2012

The International Tinnitus Journal

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“…Active maneuvers (e.g., Valsalva) to open the Eustachian tubes are usually required to equalize middle ear pressure. Thus, not surprisingly a slower compression will allow time for patients to perform the active maneuvers and reduce the rate of MEB as demonstrated by Vahidova, et al [3]. As the pressure gradient increases, these active maneuvers become increasingly difficult to perform [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, three concurrent practices are used to reduce the incidence of MEB: i) assessment to identify patient at risk of MEB; ii) teaching patients correct ear equalization techniques; iii) slow chamber compression. Vahidova et al demonstrated that the use of a slow compression technique (1.1 meters/minute vs. 2.8 meters/ minute) significantly reduced the incidence of middle ear barotrauma from 52.3% to 28.5% [3]. Most centers compress their patients to 242 kilopascals/kPa, or 2.4 atmospheres absolute/ATA over 10 to 14 minutes depending on patients' comfort and on their ability to equalize their ears.…”

Section: Introductionmentioning

confidence: 99%

Incidence of middle ear barotrauma in staged versus linear chamber compression during hyperbaric oxygen therapy: a double blinded, randomized controlled trial

Ng¹,

Müller²,

Orton³

2017

UHM

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Context: Middle ear barotrauma (MEB) is common during chamber compression in hyperbaric oxygen therapy. However, little evidence exists on an optimal compression protocol to minimize the incidence and severity of MEB.Objective: To compare the incidence of MEB during hyperbaric oxygen therapy using two different chamber compression protocols.Design: Double-blinded, randomized controlled trial. Setting: Hyperbaric Medicine Unit, The Townsville Hospital, Queensland, Australia, September 2012 to December 2014.Patients: 100 participants undergoing their first hyperbaric oxygen therapy session.Intervention: Random assignment to a staged (n=50) or a linear (n=50) compression protocols. Photographs of tympanic membranes were taken pre-and post-treatment and then graded. Middle ear _____________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________ KEYWORDS: ear barotrauma; hyperbaric oxygen therapy; middle ear; side effects barotrauma was defined as an increase of at least one grade on a modified TEED scale.Results: The observed MEB incidence under the staged protocol was 48% compared to 62% using the linear protocol (P=0.12, exact one-sided binomial test), and thus the staged protocol did not show a significant improvement in MEB. However, the staged protocol resulted in significantly less severe deteriorations in MEB grades when compared to the linear protocol (P=0.028, exact one-sided Mann-Whitney type test).Conclusion: The use of the assessed staged compression protocol for the first hyperbaric oxygen treatment showed no significant effect on the overall incidence of MEB when compared to the gold standard linear protocol but resulted in a significant improvement in the severity of the experienced MEBs. Further studies are needed to elucidate an optimal compression protocol to minimize middle ear barotrauma. INTRODUCTIONMiddle ear barotrauma (MEB) remains a common complication of hyperbaric oxygen (HBO 2 ) therapy, with the incidence ranging from 8%-68.7% [1,2]. Currently, three concurrent practices are used to reduce the incidence of MEB: i) assessment to identify patient at risk of MEB; ii) teaching patients correct ear equalization techniques; iii) slow chamber compression. Vahidova et al demonstrated that the use of a slow compression technique (1.1 meters/minute vs. 2.8 meters/

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Indications, Contraindications, and Complications of HBO Therapy

Jain¹

2017

Textbook of Hyperbaric Medicine

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Does the slow compression technique of hyperbaric oxygen therapy decrease the incidence of middle-ear barotrauma?

Abstract: The slow compression method of HBOT proved to be both safe and superior to the standard compression technique.

Cited by 14 publications

References 4 publications

Middle ear barotrauma after hyperbaric oxygen therapy - the role of insuflation maneuvers

Middle ear barotrauma after hyperbaric oxygen therapy - the role of insuflation maneuvers

Incidence of middle ear barotrauma in staged versus linear chamber compression during hyperbaric oxygen therapy: a double blinded, randomized controlled trial

Indications, Contraindications, and Complications of HBO Therapy

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