Otic barotrauma
Revisión del 23:12 10 feb 2015 de Rossdonaldson1 (discusión | contribs.) (Created page with "==Background== *Also known as "ear squeeze" during scuba diving or air flight ==Clinical Features== ====Middle Ear==== *Results from inability to equalize middle ear pressure...")
Background
- Also known as "ear squeeze" during scuba diving or air flight
Clinical Features
Middle Ear
- Results from inability to equalize middle ear pressure
- Pain, fullness, vertigo, conductive hearing loss, TM rupture
Inner Ear
- Results from forceful Valsalva against an occluded eustachian tube
- Pressure difference between middle ear and inner ear can rupture oval or round window
- Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo
Differential Diagnosis
Diving Emergencies
- Barotrauma of descent
- Otic barotrauma
- Pulmonary barotrauma
- Sinus barotrauma
- Mask squeeze
- Barodentalgia (trapped dental air causing squeeze)
- Barotrauma of ascent
- Pulmonary barotrauma (pulmonary overpressurization syndrome)
- Decompression sickness (DCS)
- Arterial gas embolism
- Alternobaric vertigo
- Facial baroparesis (Bells Palsy)
- At depth injuries
- Oxygen toxicity
- Nitrogen narcosis
- Hypothermia
- Contaminated gas mixture (e.g. CO toxicity)
- Caustic cocktail from rebreathing circuit
Workup
Management
Middle Ear
- decongestants
- consider abx if TM ruptured
Inner Ear
- Head of bed up
- no nose blowing
- antivertigo medications
- ENT consult