碩士 / 國防醫學院 / 海底醫學研究所 / 93 / ABSTRACT
Middle ear barotrauma is a frequently seen complication during exposure to abnormal environmental pressure such as diving activities and during hyperbaric oxygen therapy. The incidence of middle ear barotrauma has been linked to the function of Eustachian tube (E-tube). The patency of E-tube may possibly change due to deviation from upright posture underwater. Therefore, the study aimed to examine E-tube function at upright and prone positions. Further, the correlation of E-tube function and incidence of middle ear barotrauma was evaluated. The swallowing tests of E-tube function (with or without pinching the nose) were performed in thirty healthy volunteers in both upright and prone positions. The incidence of middle ear barotrauma was evaluated in 56 patients (111 ears) receiving hyperbaric oxygen therapy (HBOT). Tympanogram, E-tube function (by swallow test), and ability to perform Valsalva manuver were recorded prior to HBOT. Correlations between these parameters and incidence of middle ear barotrauma were made. Our results showed that postures did not affect the peak pressure changes of tympanogram during swallow test. Further, the ratio of E-tube that show good function was also not changed by postures. We did notice that pinching the nose while perform swallow movement exerted a larger peak pressure shift in tympanogram. Among the 111 ears that received HBOT for 1 to 40 sessions (with an average of 13 sessions), 54 ears suffered from middle ear barotraumas. The overall incidence was 48.6%. The occurrence of middle ear barotrauma was mostly observed in the first 5 treatment sessions with the first treatment carring the highest incidence (32/111, 32%). The symptoms of middle ear barotrauma in decreasing orders were ear fullness (54%), otalgia (41%), tinnitus (20%), impaired hearing (11%). The patterns of tympanogram, E-tube function, and ability to perform Valsalva manuver did not show significant correlation with middle ear barotrauma. Among the patients that could equalize middle ear pressure by Valsalva manuver, lack of performing Valsalva manuver during HBOT showed a significantly higher incidence of barotrauma than those that did perform it. We conclude that whether the subjects do perform middle ear pressure equalizing techniques is an important factor in determining the incidence of middle ear barotrauma. We suggest health education, training in middle ear pressure equalizing techniques and performing these techniques during pressure changes are important in preventing middle ear barotrauma.
| Identifer | oai:union.ndltd.org:TW/093NDMC0649003 |
| Date | January 2005 |
| Creators | Hui-Hsuan Huang, 黃慧璇 |
| Contributors | Bor-Hwang Kang, 康柏皇 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 82 |
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