MIDDLE-EAR BAROTRAUMA IN PATIENTS UNDERGOING HYPERBARIC-OXYGEN THERAPY

Hyperbaric oxygen therapy is associated with a risk of barotrauma to t he middle ear. This prospective study of 82 patients undergoing long-t erm therapy for chronic conditions was designed to measure the inciden ce and severity of middle ear barotrauma. Twenty-four patients (29.3%) required the insertion of ventilation tubes for otalgia, significantl y more of whom were suffering from radionecrosis of the head and neck region (P < 0.01). Thirty-two of the remaining 58 patients (55%) under went specialist ENT assessment by otoscopy and tympanometry. Five ears (8%) showed the otoscopic changes of barotrauma (TEED grade 3 or 4), and one ear (2%) showed tympanometric evidence of a middle ear effusio n (Type B tympanogram). We conclude that despite careful tuition in pr essure equalisation and the appropriate use of ventilation tubes, up t o 8% of ears sustain significant barotrauma. Tympanometry is unreliabl e in detecting these changes, otoscopy provides the most reliable scre ening technique.