INCIDENCE AND SEVERITY OF MIDDLE-EAR BAROTRAUMA IN RECREATIONAL SCUBADIVING

This prospective observational study was designed to assess the incide nce and severity of middle ear barotrauma associated with repetitive r ecreational scuba diving. Eleven healthy adult experienced scuba diver s were observed performing repetitive daily scuba diving over a 15 day period. Otoscopy and tympanometry were performed on days 0, 3, 7, 11 and 15. Participants averaged 41 dives during the study period. Mild o talgia occurred at some point in 23% of ears and subsequently resolved in all but one despite continued diving. Eight-two per cent of ears d emonstrated otoscopic evidence of middle ear barotrauma by day 3, and all exhibited barotrauma by day 11. Tympanic membrane perforation, hem otympanum, or evidence of inner ear barotrauma did not occur. Tympanom etry revealed a significant decrease in middle ear pressures but no ev idence of middle ear effusions. Gross measurements of otologic acuity and conduction remained normal. No complications or sequelae were note d at three month follow-up. Otoscopic evidence of middle ear barotraum a and tympanometric evidence of eustachian tube dysfunction developed rapidly in a group of experienced scuba divers performing repetitive r ecreational diving. Symptoms were minimal and infrequent. No serious o tologic dysfunction was noted despite continued repetitive diving, and it is possible that middle ear barotrauma at the degrees observed rep resents a more benign disorder than has been previously assumed.