Magnetic resonance imaging in a guinea pig model of inner ear decompression sickness.

[Duke Dive Medicine]

John,

The problem is more complex than simply vertigo. Hearing loss and vertigo are the two main symptoms that the authors mention, but both IEDCS and IEBT can manifest with tinnitus and gait disturbances as well; these symptoms can occur alone or in any combination. Gait disturbances can also be a symptom of cerebellar DCS, which can occur with inner ear DCS.

The differential diagnosis of vertigo alone can be difficult. Divers can suffer from acute alternobaric vertigo, usually on ascent, when one ear equalizes before the other one. The symptoms are usually transient but may persist if the other ear does not equalize immediately. Caloric vertigo can occur when the fluid in the inner ear is cooled, either by conduction in TM rupture or convection from cold water in the external ear canal. You can demonstrate this by laying on your side and filling one of your external ear canals with ice water. Make sure you have a garbage can or other waterproof container nearby if you do this.

Best regards,
DDM

 

[JohnN]

John,

The problem is more complex than simply vertigo. Hearing loss and vertigo are the two main symptoms that the authors mention, but both IEDCS and IEBT can manifest with tinnitus and gait disturbances as well; these symptoms can occur alone or in any combination. Gait disturbances can also be a symptom of cerebellar DCS, which can occur with inner ear DCS.

The differential diagnosis of vertigo alone can be difficult. Divers can suffer from acute alternobaric vertigo, usually on ascent, when one ear equalizes before the other one. The symptoms are usually transient but may persist if the other ear does not equalize immediately. Caloric vertigo can occur when the fluid in the inner ear is cooled, either by conduction in TM rupture or convection from cold water in the external ear canal. You can demonstrate this by laying on your side and filling one of your external ear canals with ice water. Make sure you have a garbage can or other waterproof container nearby if you do this.

Best regards,
DDM

Thanks and sorry to keep flogging this, however isn't IEDCS without any other symptoms of DCS a zebra?

 

[Duke Dive Medicine]

Thanks and sorry to keep flogging this, however isn't IEDCS without any other symptoms of DCS a zebra?

Not at all, and no it isn't. We've seen several incidents of lone inner ear DCS that resolved with hyperbaric O2 treatment.

Best regards,
DDM

 

[JohnN]

Not at all, and no it isn't. We've seen several incidents of lone inner ear DCS that resolved with hyperbaric O2 treatment.

Best regards,
DDM

So the authors say:

Decompression sickness requires costly and potentially dangerous hyperbaric therapy, whereas such treatment may worsen barotrauma [/QUOTE}

Is hyberbaric treatment contraindicated for IEBT ?

 

[Duke Dive Medicine]

It's definitely not indicated. IEBT could be exacerbated by the pressure changes, thus the importance of differential diagnosis. There are times, however, when differential diagnosis is not possible. Then, depending on the case, the decision could be made to treat the individual in the hyperbaric chamber because the consequences of failing to treat inner ear DCS may be worse than pressurizing someone with IEBT. From a practical standpoint, this could involve myringotomies (incisions in the tympanic membrane) to help mitigate any pressure differential as the ambient pressure in the chamber changes.

Best regards,
DDM

 

[dreamdive]

I love the replies given by DDM. They are always highly professional and should serve as role models for any discussion rather than the negative, trashing, demeaning comments often posted by others.

 

[afdgf]

A poster does not pad a cv very much. Posters are frequently done at the early stages of research when the presenter just wants to get some feedback from peers about ideas that are not yet fully developed. A lot of very exploratory work is presented as posters and then never goes beyond that. The fact that this work that may have included some errors was presented as a poster was entirely appropriate.

 

[JohnN]

A poster does not pad a cv very much. Posters are frequently done at the early stages of research when the presenter just wants to get some feedback from peers about ideas that are not yet fully developed. A lot of very exploratory work is presented as posters and then never goes beyond that. The fact that this work that may have included some errors was presented as a poster was entirely appropriate.

Ahh but for academia, a poster counts as scholarship (a requirement to obtain or retain tenure)

 

[afdgf]

Actually a poster does not contribute to obtaining tenure or promotion. You could have 1,000 posters and still not get tenure. You must have at least one peer-reviewed journal article per year at our university (for a total of 5 before promotion and tenure) and that is a fairly low bar. Carnegie one universities require a lot more. Posters are not a requirement for tenure or promotion. They are neither necessary nor sufficient for tenure or promotion. Peer-reviewed journal articles are.

 

[Duke Dive Medicine]

Claudia, thanks for the kind words.