The Effect of Flight on the Middle Ear

Armstrong, Harry G.

doi:10.1001/jama.1937.02780320019007

Cited by 102 publications

(28 citation statements)

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“…The importance of these effects in aviation medicine have been discussed by Armstrong (15)(16)(17). In caisson disease, the data of Heller et al, quoted by Hill (129), showed that ear difficulties constituted about 2l.b r < of the total symptoms.…”

Section: Effects On the Earmentioning

confidence: 99%

“…In some individuals, the tympanum might possibly rupture since a differential pressure between 100 to 500 mm. Hg can cause rupture (17). Behnke (23) gives the values at between 250 to 500 mm.…”

Section: Barntrnumaticmentioning

confidence: 99%

“…When a "negative pressure" of from 80 to 90 mm. Hg is developed in ttie middle ear, then the fibrocartilaginous portion of the eustachian tube is collapsed and the two chief muscles (tensor veli palatinitonses the soft palate and opens the eustachian tube; salpingo-} '.aryngeus-raises the upper and lateral parts of the pharynx and opens the ostium of the eustachian tube) cannot overcome negative pressures of this magnitude (17). In other words, such voluntary efforts as swallowing and yawning are inadequate to open the eustachian tube and ascent to lower pressure should be made to decrease the magnitude of the differential pressure.…”

Section: Figurementioning

confidence: 99%

“…Tables XXVIII and XXIX hate been tabulated from Armstrong and Heim (17). The following is quottd directly because of its descriptive excellence (17):…”

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confidence: 99%

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Dysbarism

Adler¹

1964

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Section: Effects On the Earmentioning

confidence: 99%

Section: Barntrnumaticmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

“…Tables XXVIII and XXIX hate been tabulated from Armstrong and Heim (17). The following is quottd directly because of its descriptive excellence (17):…”

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Dysbarism

Adler¹

1964

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“…It is well known that inability to clear the ears in flight may lead to temporary hear ing loss, pain and vertigo to an extent that will compromise flight safety and lower the mission capacity o f the aircrew [1,11], We have reason to doubt the present selection requirements of tubal function since ear trou ble, usually during a common cold, is one of the most common causes o f temporary grounding [1,2]. In addition, it is considered difficult clinically to determine when an air man has regained his normal tubal function after a cold, since normal findings in a con ventional ENT-examination cannot guaran tee a normalized tubal function.…”

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confidence: 99%

Pressure Chamber Tests for Selection of Aircrew

Groth

Tjernström

1984

ORL

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The Eustachian tube function requested from flying personnel today is generally regarded as acceptable if hearing and otoscopic findings are normal and there is no history of ear disease. Since increasing performance of modern aircrafts place more rigorous demands on the equilibrating capacity of the Eustachian tube and difficulty to clear the ears already is the most common cause of temporary grounding among flying personnel, the present requirements for tubal function might gradually get more and more inefficient. Inability to equilibrate in flight may lead to temporarily reduced hearing, acute ear pain and alternobaric vertigo that will affect the pilot’s capacity and thus constitute a problem of flight safety. A testing procedure that makes it possible to continuously measure the middle ear pressure in subjects with intact eardrums during simulated flights in a pressure chamber would introduce a possibility to find basic medical standards of Eustachian tube function to be used in the selection of flying personnel. Student pilots, accepted for primary flight training, were examined in the present study by such a method. A comparison is made with the results of other tests of the Eustachian tube function in order to find out the relevance of the latter tests in the selection of flying personnel. The results are presented and discussed.

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The Eustachian Tube: Abnormal Patency and Normal Physiologic State

Perlman¹

1939

Archives of Otolaryngology - Head and Neck Surgery

126

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writing about the ear in his monumental handbook of physiology, stated that he could produce a snapping sound in his ears associated with contraction of the palatine muscles and elevation of the soft palate. He said, "If immediately afterwards I emit a humming vocal tone while my mouth is either closed or only slightly open, this tone has an extraordinary resonance." He could not explain this phenomenon but believed that it had something to do with the contraction of the tensor tympani muscle ; while he had given much thought to the function of the eustachian tube, he did not correlate the phenomenon with its opening. He believed that it is continuously open. It was Toynbee,2 in 1853, who concluded from experiments on himself and from the tendency to swallow while descending in a diving bell that the eustachian tube is normally closed and opens only during the act of swallowing. He found that by swallowing with the nose closed (Toynbee's maneuver) a sensation of fulness, or distention, is produced in the ears, which remains on removing the hand from the nose.He concluded that this is due to the forceful entrance of air into the middle ear and that the resultant increase in pressure is maintained by the closed state of the eustachian tube. That this sense of pressure is relieved by swallowing with the nose open indicated to him that the tube opens only during the act of swallowing. It was some time later (1864) that Politzer3 showed by his experiments with a manometer sealed in the external auditory canal that Toynbee's maneuver results in a negative pressure, or exhaustion of air, in the middle ear. It was noted also that Toynbee's maneuver is usually associated with a distinct movement of the drum. The contention of Toynbee that the tube is From the

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The Effect of Flight on the Middle Ear

Cited by 102 publications

References 1 publication

Dysbarism

Dysbarism

Pressure Chamber Tests for Selection of Aircrew

The Eustachian Tube: Abnormal Patency and Normal Physiologic State

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