Recurrent diving-related inner ear barotrauma

Abstract

Objective: To present two cases of recurrent diving-related inner ear barotrauma (IEB) and to discuss the possible cause and pathogenesis of the increased inner ear vulnerability.

Study design: Case series.

Setting: Tertiary referral center.

Patients: Two scuba divers suffering from repeated cochleovestibular barotrauma.

Interventions: Neurotological evaluation, perilymphatic fistulae repair, and conservative treatment.

Main outcome measure: The increasing popularity of scuba diving expose the individuals involved in this sport to unique pathologies that are not common under terrestrial conditions. The otolaryngologist who is involved in the care of these patients is required to diagnose and treat diving-related ear injuries and to consider the risk for recurrent inner ear injury when diving is resumed.

Conclusion: IEB carries a risk for permanent hearing loss and chronic vestibulopathy. We recommend complete neurotological evaluation including high-resolution CT of the temporal bones as a routine workup for IEB. The presence of a significant residual sensorineural hearing loss, evidence for noncompensated vestibular damage, and CT findings of possible enhanced cerebrospinal fluid-perilymph connection should be considered when a return to diving activity is considered.