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. 2025 Aug 20;10(4):e70241.
doi: 10.1002/lio2.70241. eCollection 2025 Aug.

Evaluation of the Peripheral Vestibular System due to Inner Ear Barotrauma in the Hyperbaric Environment

Ömer Bozkurt  1 , Selis Gülseven Güven  2 , Memduha Taş  3 , Şule Yılmaz  3 , Ahmet Köder  2 , Erdoğan Bulut  3   4   5
Affiliations

Evaluation of the Peripheral Vestibular System due to Inner Ear Barotrauma in the Hyperbaric Environment

Ömer Bozkurt et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objectives: The aim of this study was to investigate changes that may occur in the peripheral vestibular system due to inner ear barotrauma in self-contained underwater breathing apparatus (SCUBA) divers exposed to hyperbaric environments.

Methods: This prospective study was conducted on 45 healthy volunteers. In this study, after otologic and audiological examinations were performed on two groups as control (n = 24) and SCUBA (n = 21), cervical vestibular evoked myogenic potentials (c-VEMP) were evaluated for peripheral vestibular system functions. The SCUBA group comprised individuals who had completed a minimum of 75 dives and held a World Confederation of Underwater Activities 2 certificate. Statistical analysis was performed on immittance metric measurements, pure-tone hearing thresholds (0.5-18 kHz), and P1-N1 latencies and amplitudes from c-VEMP tests.

Results: The SCUBA group demonstrated statistically significant differences in pure-tone low and high frequency thresholds within the normal hearing range compared to the control group (p = 0.001). The c-VEMP responses showed statistically significant prolongation of P1-N1 latencies in right ears and N1 latencies in left ears in the SCUBA group (p < 0.05), along with a statistically significant increase in amplitudes (p = 0.0001).

Conclusion: Based on our findings, the increased amplitudes in c-VEMP responses observed in SCUBA divers exposed to hyperbaric environments suggest enhanced saccular plasticity, likely resulting from barotrauma effects on otolith structures.

Level of evidence: 3.

Keywords: barotrauma; diving; ear; inner; vestibular evoked myogenic potential; vestibular system.

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Conflict of interest statement

The authors declare no conflicts of interest.

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