Pathogenetic factors for middle ear barotrauma during hyperbaric oxygen therapy

doi:10.3321/j.issn:1673-8225.2004.14.006

Abstract：BACKGROUND: A variety of pathogenetic factors have been identified for their involvement in middle ear barotrauna during hyperbaric oxygen therapy. but the question of what factors, independently or in cooperation, cause the injury remains unanswered.OBJECTIVE: To analyze the reasons for middle ear barotrauma during hyperbaric oxygen therapy and explore the possible preventive measures.DESIGN: A retrospective study was conducted.SETTINGS and PARTICIPANTS: Eighty-four patients with middle ear barotrauma identified from in 2 116 patients receiving hyperbaric oxygen therapy in Guangzhou General Hospital of Guangzhou Command were enrolled in this study, including 61 male and 23 female patients aged from 6 to 78 years old.METHODS: The background factors were analyzed in the 84 cases of middle ear barotrauma.pressure adjustment either simply not performed or failed to be performed due the barotrauma.RESULTS: Middle ear barotrauma occurred in the compression stage in 76 cases and in the decompression stage in 8 cases for reasons of obstruction of the auditory tube, inappropriate pressure adjustnent or inappropriate chamber operation. In the 3 classes of identified causes, obstruction in the auditory tube was the most frequent single pathogenetic factor for the injury, while auditory tube obstruction coupled with inappropriate pressure adjustment was responsible for most cases of middle ear barotrauma involving multiple factors.CONCLUSION: Both single and multiple factors can cause middle ear barotrauma during hyperbaric oxygen therapy, which can be prevented by carefully controlling all the factors involved in each procedure before, during and after the treatment.