Abstract
It is known that sudden changes of atmospheric pressure can damage the acoustic organs. We have used hyperbaric oxygen therapy for patients with sudden deafness and Bell's palsy. During this therapy, barotrauma of the middle ear has been observed in some patients. However, it disappears spontaneously and no inner ear barotrauma has been observed. The prognosis is generally good in middle ear barotrauma.
We treated 136 patients with inner ear barotrauma caused by diving, landing or taking off in an airplane, blowing the nose, blast injury, etc. Of these patients, only 27% had combined middle ear barotrauma. In the early stage, complete hearing recovery was expected in most cases. Of 16 patients, whom we treated with exploratory tympanotomy, rupture of the round window membrane was found in 5 and rupture of both the round and oval window membranes in 1.
As to the cause of aural barotrauma, we speculated that the change of pressure directly affected the mucous membrane of the middle ear, but in inner ear barotrauma the change of pressure was transmitted to the inner ear through the labyrinthine window membranes, and had a strong effect on the endolymph, which damaged sensory hair cells. The results of experimental studies on guinea pigs confirmed this speculation.
