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Comprehensive information
about
diving and undersea medicine for the non-medical diver, the non-diving
physician and the specialist.
Inner Ear Problems
Dr. Murray Grossan feels that the best way to diagnose
perilymph
fistula is as follows:
"I notice that one of the reasons perilymph fistula is missed
so often is that the "textbooks" state to use the otoscope and rubber
bulb
to increase pressure on the middle ear to elicit dizziness. This
doesn't
work.
It is actually necessary to use a tympanometer and an
experienced
audiologist who has done many of these tests. In tympanometry, the ear
is sealed and an exact pressure is placed against the ear drum, both
positive
and negative. By putting excessive pressure - measured by the machine -
you
can then determine if dizziness occurs and if you can see
nystagmus.
I routinely see cases missed because they relied on the otoscope and
rubber
bulb for the test."
Inner Ear Decompression Sickness (IEDCS)--manifested by tinnitus, vertigo, nausea, vomiting, and hearing loss--is usually associated with deep air or mixed gas dives, and accompanied by other CNS symptoms of decompression sickness (DCS). Early recompression treatment is required in order to avoid permanent inner ear damage. They present an unusual case of a scuba diver suffering from IEDCS as the only manifestation of DCS following a short shallow scuba dive, successfully treated by U.S. Navy treatment table 6 and tranquilizers. This case suggests that diving medical personnel should be more aware of the possible occurrence of IEDCS among the wide population of sport scuba divers. Aviat Space Environ Med 61 (6): 563-566 (Jun 1990)
Inner ear decompression sickness (IEDCS) is one
form
of Type II decompression sickness. Most cases of IEDCS have been
associated
with saturation dives, so there are very few reports of occurrence
following
shallow scuba dives. They present a case of a diver who suffered from
IEDCS
following a shallow scuba dive (30m), and was successfully treated by
the
protocol outlined in U.S. Navy treatment table 6. This case suggests
that
there is the possibility of occurrence of IEDCS, even following a
shallow
scuba dive, if proper decompression procedures are not adhered to. In
addition,
detailed analysis of diving profiles should be used to distinguish the
inner ear dysfunction seen in some divers from inner ear barotrauma
which
may be attributable to IEDCS. Nippon Jibiinkoka Gakkai Kaiho 95 (4):
499-504
(Apr 1992).
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Ernest Campbell, MD, FACS All Rights Reserved. |