The Study on the Preventive Method of the Middle Ear Barotrauma Caused by Hyperbaric Oxygen Therapy

Kang, Chang Il; Na, Jong Won; Kim, Sung Kon; Choi, Won Chan; Park, Min Kyu; Lee, Su Young

Abstract

BACKGROUND AND OBJECTIVES: Middle ear barotrauma is a damage of the ear resulting from the pressure difference between the middle ear and the atmospheric environment. We investigated the effects of chewing gum and administering the systemic decongestant in hyperbaric oxygen therapy. MATERIALS AND METHOD: We investigated the cases of the middle ear barotrauma which came from hyperbaric oxygen therapy for finger replantation. We studied 81 patients without E-tube dysfunction. They were divided into three groups: the non-treated patients, the patients chewing gums and receiving high-pressure treatment, and the patients receiving the systemic decongestant. We investigated the patients for symptoms, otoscopic findings, tympanometry, and PTA. Otoscopic findings were classified by modified Teed classification.
RESULTS
In the first group, 36 of 60 (60%) ears had otologic symptoms, 37 of 60 (62%) ears were above the grade 1, 31 of 60 (52%) ears were B or C type in tympanometry and 20 of 60 (33%) ears were above 20dB in AB gap (air-bone gap). In the second group, 23 of 60 (38%) ears had the otologic symptom, 26 of 60 (43%) ears were above the grade 1, 19 of 60 (32%) ears were the B or C type and 10 of 60 (17%) ears were above 20dB in AB gap. In the third group, 18 of 42 (43%) ears had the otologic symptoms, 19 of 42 (45%) ears were above the grade 1, 15 of 42 (36%) ears were the B or C type and 7 of 42 (17%) ears were above 20dB in the AB gap.
CONCLUSION
The second group was better than the first group with regard to otologic symptom, otoscopic findings, tympanometry, PTA, and showed statistical significance. On the other hand, the third group was effective but did not show statistical significance.