Oskari H Lindfors1,2, Anne K Räisänen-Sokolowski3,4, Jari Suvilehto5, Saku T Sinkkonen1. 1. Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 2. Corresponding author: Oskari H Lindfors, Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital, P.O. Box 263, FI-00029 HUH, Helsinki, Finland, oskari.lindfors@helsinki.fi. 3. Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 4. Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland. 5. Mehiläinen Oy, Helsinki, Finland.
Abstract
INTRODUCTION: Middle ear barotrauma (MEBt) is the most common medical complication in diving, posing a serious risk to dive safety. Given this prevalence and the continuing growth of the diving industry, a comprehensive overview of the condition is warranted. METHODS: This was a survey study. An anonymous, electronic questionnaire was distributed to 7,060 recipients: professional divers of the Finnish Border Guard, the Finnish Rescue Services, and the Finnish Heritage agency; and recreational divers registered as members of the Finnish Divers' Association reachable by e-mail (roughly two-thirds of all members and recreational divers in Finland). Primary outcomes were self-reported prevalence, clinical characteristics, and health effects of MEBt while diving. Secondary outcomes were adjusted odds ratios (OR) for frequency of MEBt with respect to possible risk factors. RESULTS: A total of 1,881 respondents participated in the study (response rate 27%). In total, 81% of the respondents had experienced MEBt while diving. Of those affected, 38% had used medications and 1% had undergone otorhinolaryngology-related surgical procedures due to MEBt. Factors most associated with MEBt were poor subjective success in Valsalva ('occasionally' versus 'always' successful: OR 11.56; 95% CI 7.24-18.47) and Toynbee ('occasionally' versus 'always' successful: OR 3.51; 95% CI 1.95-6.30) manoeuvres. CONCLUSIONS: MEBt is common in both recreational and professional divers, having affected 81% of the respondents. The main possible risk factors include poor success in pressure equalisation manoeuvres. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
INTRODUCTION: Middle ear barotrauma (MEBt) is the most common medical complication in diving, posing a serious risk to dive safety. Given this prevalence and the continuing growth of the diving industry, a comprehensive overview of the condition is warranted. METHODS: This was a survey study. An anonymous, electronic questionnaire was distributed to 7,060 recipients: professional divers of the Finnish Border Guard, the Finnish Rescue Services, and the Finnish Heritage agency; and recreational divers registered as members of the Finnish Divers' Association reachable by e-mail (roughly two-thirds of all members and recreational divers in Finland). Primary outcomes were self-reported prevalence, clinical characteristics, and health effects of MEBt while diving. Secondary outcomes were adjusted odds ratios (OR) for frequency of MEBt with respect to possible risk factors. RESULTS: A total of 1,881 respondents participated in the study (response rate 27%). In total, 81% of the respondents had experienced MEBt while diving. Of those affected, 38% had used medications and 1% had undergone otorhinolaryngology-related surgical procedures due to MEBt. Factors most associated with MEBt were poor subjective success in Valsalva ('occasionally' versus 'always' successful: OR 11.56; 95% CI 7.24-18.47) and Toynbee ('occasionally' versus 'always' successful: OR 3.51; 95% CI 1.95-6.30) manoeuvres. CONCLUSIONS: MEBt is common in both recreational and professional divers, having affected 81% of the respondents. The main possible risk factors include poor success in pressure equalisation manoeuvres. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Authors: A G M Schilder; M F Bhutta; C C Butler; C Holy; L H Levine; K J Kvaerner; G Norman; R J Pennings; D Poe; J T Silvola; H Sudhoff; V J Lund Journal: Clin Otolaryngol Date: 2015-10 Impact factor: 2.597
Authors: Oskari H Lindfors; Anne K Räisänen-Sokolowski; Jari Suvilehto; Saku T Sinkkonen Journal: Diving Hyperb Med Date: 2021-06-30 Impact factor: 1.228