Barotrauma Of The Ears And The Sine

Barotrauma is a tissue injury, caused the volume of gas in the body cavity by a pressure-induced change, you can affect the ear (causing ear pain, hearing loss and / or vestibular symptoms) or sinuses (causing pain and congestion). The diagnosis sometimes requires audiometry and vestibular tests. Treatment, if necessary, may include decongestants, analgesics and sometimes oral corticosteroids or surgical repair of severe internal or middle ear or sinus injury.

Diving can affect the outer, middle and inner ear. Typically, the diver ear pressure or pain feels during submarining; when the pressure is not equalized quickly, can cause middle ear hemorrhage or tympanic membrane. The inflow of cold water in the middle ear can cause dizziness, nausea and disorientation during a dive. On examination of the external auditory canal, the tympanic membrane may comprise a pneumatic otoscope a congestion sign of Hämatotympanons or perforation and lack of mobility during the blowing of air; often there is a middle ear hearing loss.

Barotrauma is a tissue injury, caused the volume of gas in the body cavity by a pressure-induced change, you can affect the ear (causing ear pain, hearing loss and / or vestibular symptoms) or sinuses (causing pain and congestion). The diagnosis sometimes requires audiometry and vestibular tests. Treatment, if necessary, may include decongestants, analgesics and sometimes oral corticosteroids or surgical repair of severe internal or middle ear or sinus injury. Diving can affect the outer, middle and inner ear. Typically, the diver ear pressure or pain feels during submarining; when the pressure is not equalized quickly, can cause middle ear hemorrhage or tympanic membrane. The inflow of cold water in the middle ear can cause dizziness, nausea and disorientation during a dive. On examination of the external auditory canal, the tympanic membrane may comprise a pneumatic otoscope a congestion sign of Hämatotympanons or perforation and lack of mobility during the blowing of air; often there is a middle ear hearing loss. When barotrauma of the inner ear often there is a rupture of the round or oval window, which causes tinnitus, sensorineural hearing loss, dizziness, nausea and vomiting. The resulting Labyrinthfistel and leakage of perilymph can damage permanently the inner ear. Barotrauma sinus affects primarily the frontal sinus, followed by the ethmoid sinus and the maxillary sinus. The divers feel during ascending or submarining a slight pressure to severe pain, along with a sense of congestion in the affected paranasal sinuses and sometimes epistaxis. The pain can be strong and sometimes they are accompanied by tenderness in the area of ??the face. Rarely has a sinus may rupture and cause a Pneumatozephalus with pain in the face and mouth, nausea, dizziness or headache. The rupture of a maxillary sinus can lead to retro-orbital air with diplopia due to the oculomotor dysfunction. The compression of the trigeminal nerve in the antrum can cause Gesichtsparästhesien. On physical examination, a sensitivity in the area of ??the sinuses or nose bleeds can be found. Diagnostic audiometry and vestibular testing patients with symptoms of injury to the inner ear should be examined for signs of vestibular and help be reviewed by audiometry and vestibular tests. Imaging techniques (eg. As plain X-ray, CT) are not necessary diagnostic, although a CT can be useful when a Sinusruptur is suspected. Decongestants therapy and analgesics Sometimes oral corticosteroids, surgical repair or both Most injuries from barotrauma to the ear, and sinus spontaneously disappear by themselves and require only treating the symptoms and outpatient treatment. Drug treatment for sinus and Mittelohrbarotrauma is identical. Decongestant medications (usually oxymetazoline 0.05%, 2 spray shocks in each nostril two times daily for 3-5 days; pseudoephedrine 60-120 mg po 2 to 4 times a day up to a maximum dose of 240 mg / day 3-5 days) may help to open clogged sinuses. Severe cases can be treated with intranasal corticosteroids. If immediately after the nasal spray therapy a Valsalva maneuver is carried out, this can help to distribute the decongestant medication in the clogged sinuses. The pain can be controlled with nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids. If bleeding or the detection of bruises are present, an antibiotic is administered (e.g., amoxicillin 500 mg p.o. every 12 h for 10 days;. Trimethoprim-sulfamethoxazole 1 tablet double thickness p.o. 2 times a day for 10 days). In a Mittelohrbarotrauma, some doctors refer to as a course of treatment with corticosteroids from (eg. Prednisone 60 mg / day po for 6 days, then about 7-10 days gradually tapered off). Referral to an ear, nose and throat specialist is indicated for severe or persistent symptoms. An operative treatment (eg. B. tympanotomy for direct restoration of a ruptured round or oval window, myringotomy for draining fluid from the middle ear, Sinusdekompression) may be necessary for heavy heart and middle ear or sinus injury. A prevention Ohrbarotrauma can be avoided by frequent swallowing or breathing out against delivered preserved nostrils to open the eustachian tube and for equalizing pressure between the middle ear and the surroundings. The pressure downstream of earplugs can not be balanced, therefore they should not be used for diving. The prophylactic administration of pseudoephedrine (60-120 mg p.o. 2 to 4 times a day up to a maximum dose of 240 mg / day) beginning 12-24 hours prior to dipping can reduce the incidence of ear and Sinusbarotraumata. It should not be submerged when the congestion is not resolved or an infection of the upper respiratory tract or uncontrolled allergic rhinitis is. Important Points When patients have tinnitus, hearing loss or dizziness should be done audiometric and vestibular tests. A CT should be performed when a Sinusruptur is suspected. If symptoms are severe, analgesic and decongestant drugs are prescribed. The risk of ear and Nebenhöhlenbarotraumata is lowered when the Council is followed, not to dive at verstopfer nose or if prophylactic pseudoephedrine is prescribed. For more information Divers Alert Network: 24-hour emergency hotline, 919-684-9111

Health Life Media Team

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