Predictors of middle ear barotrauma associated with hyperbaric oxygen therapy.

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Predictors of middle ear barotrauma associated with hyperbaric oxygen therapy.

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Title: Predictors of middle ear barotrauma associated with hyperbaric oxygen therapy.
Author: Lehm, JP; Bennett, MH
Abstract: Introduction: Middle ear barotrauma (MEBT) is a relatively common complication of hyperbaric oxygen therapy (HBO2). Many factors have been reported to increase the risk of this complication. This study investigates risk factors for MEBT associated with the initiation of HBO2. Methods: Patients scheduled for elective HBO2 were recruited over a 12-month period. Possible risk factors for MEBT on history and examination were recorded prior to the initial HBO2. During or immediately after this initial treatment, the presence of ear symptoms or new otoscopic tympanic membrane (TM) changes were determined as evidence of MEBT. Results: Sixty subjects contributed data during the study period. The initial HBO2 session was associated with mild MEBT in 43% of patients and in 32% of ears. There were no cases of free blood in the middle ear or perforated TM. MEBT was positively correlated with an immobile TM on otoscopy during the Valsalva manoeuvre. Multivariate logistic regression suggests the risk of MEBT can be predicted from the results of TM otoscopy during Valsalva manoeuvre and tympanograms before and after Valsalva (dynamic tympanogram). Conclusions: MEBT is common in patients starting HBO2. Patients can be stratified into low-, intermediate- and high-risk groups on the basis of the combined information from otoscopic visualisation of the mobility of the TM during Valsalva and dynamic tympanograms.
Description: Journal of the South Pacific Underwater Medicine Society.
URI: http://archive.rubicon-foundation.org/8076
Date: 2003

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