Embolic Inner Ear Decompression Illness: Correlation With a Right‐to‐Left Shunt

Otology &Amp; Neurotology

Praetorius

Baumann

et al. 2007

Self Cite

We describe for the first time a patient with bilateral manifestation of inner ear decompression illness. Inner ear decompression illness is frequently associated with a R/L shunt; therefore, after a diving accident, the patient's fitness to dive should be assessed via a specialist in diving medicine. Both decompression illness and barotrauma of the inner ear result in residual cochleovestibular damage in more than three of four patients.

Section: Decompression Illness Of the Inner Earmentioning

confidence: 62%

“…Depending on the amount of Doppler signals, the R/L shunt was classified into small when more than 5 but fewer than 20 signals could be found and into large when more than 20 bubbles were detected in the arterial system. This method has been published in detail before (12).…”

Section: Doppler Sonography To Detect a Right-to-left Shuntmentioning

confidence: 99%

Barotrauma and Decompression Illness of the Inner Ear

Otology &Amp; Neurotology

Praetorius

Baumann

et al. 2007

Self Cite

“…Die Dekompressionserkrankung des Innenohrs zählt zur Dekompressionserkrankung Typ II und ist in der überwiegenden Zahl mit einem kardialen Rechts-Links-Shunt assoziiert [2,5]. Ein solcher Rechts-LinksShunt begünstigt die Arterialisierung venöser Gasbläschen, die in der Folge zu  embolischen Gefäßverschlüssen führen können.…”

Section: Mittelohrunclassified

Tauchmedizinische Aspekte in der HNO-Heilkunde

Wallner

2004

HNO

Diving has become increasingly popular. With the growing number of patients who want to dive, there is an increasing number of divers who require their regular medical examination. As ENT problems are the most common disorders in divers, otorhinolaryngologists regularly have to assess the diver's fitness. It should be noted that an ENT examination does not certify complete fitness to dive! Diving can be resumed 3 months after middle ear surgery, especially after tympanoplastic type I, II and III with insertion of a PORP, when there is regular middle ear ventilation without atrophic scars of the tympanic membrane. Even after stapes surgery, diving can be resumed when there are no signs of vestibular irritation during a provocation test. By 3 months after sinus surgery, the diver should perform a test dive under supervision before fitness to dive can be certified. After inner ear barotrauma, the diver remains fit to dive depending on his hearing ability in the involved ear. After inner ear decompression illness, one should look for a vascular right-to-left shunt before diving can be resumed. These and many more aspects are discussed in this article on how to determine whether a diver with ENT problems is fit to dive.

“…Durch die beidseitige Parazentese ist es möglich, sowohl Taucher mit Barotrauma als auch Taucher mit Dekompressionserkrankung ohne die Gefahr einer Schädigung des Innenohrs zu therapieren. Dem behandelnden Arzt wird somit die Entscheidung für eine hyperbare Sauerstofftherapie wesentlich erleichtert [6].…”

Section: Differenzialdiagnose Zwischen Barotrauma Und Dekompressionseunclassified

“…Aktuelle Berichte zeigen jedoch, dass sie weitaus häufiger vorkommt als man bisher annahm. Es scheint sich sogar herauszustellen, dass die Dekompressionserkrankung des Innenohrs eine der häufigsten Formen der schweren Dekompressionserkrankung ist[4,6,13].Symptome. Man unterscheidet eine mildere Form der  Dekompressionserkrankung (Typ I) mit Symptomen im Bereich der Haut, Muskulatur und Gelenke, von einer schweren Form der  Dekompressionserkrankung (Typ II) mit kardiovaskulären, pulmonalen oder neurologischen Symptomen.…”

unclassified

Tauchmedizinische Aspekte in der HNO-Heilkunde

Wallner

2004

HNO

There has been a steady increase in the number of recreational scuba divers in the last years, with a growing number of diving associated diseases involving ENT medicine. Disorders of the ears, sinuses and pharynx are those most common in divers. In particular, external otitis and barotrauma of the middle ear are commonly treated by every ENT specialist. They usually do not lead to any permanent complaints. Incidents involving the cochleovestibular system are less common, but can result in deafness, vertigo and tinnitus, and therefore have to be treated appropriately. To treat diving medical disorders, the physician has to have some basic understanding of the physical laws that lead to diving incidents. This article will inform the reader of the forces that are encountered by divers, and then give details of the treatment of acute ENT diseases which result from diving incidents.