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Inner Ear Decompression Sickness in Sport Compressed‐Air Diving
Author(s) -
Nachum Zohar,
Shupak Avi,
Spitzer Orna,
Sharoni Zohara,
Doweck Ilana,
Gordon Carlos R.
Publication year - 2001
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200105000-00018
Subject(s) - medicine , decompression sickness , decompression illness , decompression , vestibular system , surgery , vertigo , anesthesia , vestibule , inner ear , audiology , anatomy
Objective We report our experience over the past 12 years with recreational diving‐related inner ear decompression sickness (IEDCS). Study Design Retrospective, consecutive case series. Methods Twenty‐four divers, representing 29 cases of IEDCS, are presented with regard to evaluation, treatment, and follow‐up. Results These 29 cases represent 26% of the severe decompression sickness (DCS) cases treated in that period. The patient group includes 22 divers who had a single event of IEDCS, one diver who had two events, and one with five repeated episodes. The cause of injury in 23 cases (79%) was violation of the decompression schedule. The mean time from surfacing to appearance of symptoms was 47 ± 65 minutes. In 83%, symptoms appeared within 1 hour of ascent, in 97% within 2 hours, and in only one diver after 5.5 hours. Ten divers (34%) had pure vestibular involvement, 4 (14%) had cochlear insult alone, and 15 (52%) had combined vestibulo‐cochlear injury. Except for one patient who had central as well as peripheral vestibulo‐cochlear DCS, all the remaining patients had end organ involvement only, as demonstrated by physical examination and laboratory test results. Fifteen (52%) had isolated IEDCS, whereas 14 had additional symptoms of DCS. Twenty‐six cases were treated by hyperbaric oxygenation with supplementary daily hyperbaric sessions. Of the 25 cases with vestibular injury and the 19 with cochlear damage, only 7 (28%) and 6 (32%), respectively, made a full recovery, whereas the others remained with residual damage. Of the 17 treated within 6 hours of symptom appearance, 9 (53%) were cured, compared with one of the 9 treated later ( P <.05). Conclusions IEDCS related to compressed‐air recreational diving is more common than previously thought, and might occur even when no decompression schedule violation took place. Prompt diagnosis leading to the early commencement of hyperbaric oxygen recompression therapy is the key to complete recovery of cochlear and vestibular function.