Considerations of the pathophysiology and histopathology of deafness associated with decompression sickness and absence of middle-ear barotrauma

Abstract

Dr. J. Donald Harris has previously speculated in the literature that, based on clinical impressions, a group of Navy Divers with post-dive deafness and/or vestibular attacks may have suffered inner-ear hemorrhage. We have found hemorrhage in the inner ear of a guinea pig sacrificed 16 days after a post-dive vestibular attack with cochlear potential function loss. In terms of potential treatment for human divers it is important to determine how soon after the onset of an attack inner-ear hemorrhage can occur. We now have an additional guinea pig with a severe post-dive cochlear potential loss which was sacrificed for histology at 21 hours post-dive. This animal shows a plasma exudate in the inner ear, but no red cells are present. The similarity of these two pathology cases to the results of sympathetic nervous system stimulation by Seymour and Tappin reported in 1953 is discussed. We also consider the possibility that hypercoagulation, embolic, and thrombotic problems may be involved in the etiology of the diving-deafness syndrome. Preliminary results of post-diving deafness treatment with urokinase and urokinase plus heparin are also discussed.