Prevalence of middle ear barotrauma in recreational scuba after repetitive dives.

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DocVikingo

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The bane of extended dive trips--wear & tear on the Eustacian tubes and middle ear space.

Interesting that the prevalence of MEB increased significantly with number of dives per day, but not with depth nor duration of dives since both of the later also would be expected to entail an increased number of equalizations. Perhaps it's that first atmosphere that does the lion's share of the damage.

Not surprising that prevalence was reduced in more experienced divers, who presumably are more accomplished at equalizing early, often & gently.

"Otol Neurotol. 2016 Oct;37(9):1325-31.

Prevalence of Barotrauma in Recreational Scuba Divers After Repetitive Saltwater Dives.

Abstract

INTRODUCTION:

The aim was to investigate the prevalence of middle ear barotrauma (MEB) and to establish risk factors of MEB after repeated saltwater dives.

METHODS:

In this prospective observational cohort study 28 divers were examined over 6 consecutive days of diving in the Red Sea, Egypt. Participants underwent an otoscopic examination before the first dive, between each dive and after the last dive. In addition, they performed Valsalva maneuver (VM) and were questioned about dive-related complaints. Otoscopic findings were classified according to TEED classification for MEB (0 = normal otoscopy to 4 = perforation) separately for each ear. First examination was conducted before the first dive. Final examination, including a questionnaire, was conducted at least 12 h after the last dive.

RESULTS:

In total, 436 dives were performed and 1161 otoscopic findings were analyzed. All participants showed a normal eardrum and a positive VM during initial exam. MEB prevalence (TEED >0) was 36.5% at final examination. Prevalence increased significantly with number of dives per day (p < 0.001) as with number of diving days (p = 0.032). Neither depth nor duration of dives significantly influenced MEB prevalence (all p > 0.05). More experienced divers (>200 dives lifetime) showed significantly less barotrauma (p < 0.0001). Despite the high prevalence of MEB, 81.7% (316 of 387) of all dives were reported asymptomatic.

CONCLUSIONS:

After 6 days of repetitive diving, MEB prevalence was high (36.5%). It was the most often cause of otalgia in divers. Cumulative pressure exposure during repetitive dives resulted in significant increase of MEB. Diving experience significantly reduced the MEB prevalence. Interestingly, the severity of MEB did not correlate with subjective complaints."

Regards,

DocVikingo
 

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