高圧酸素治療による中耳圧力損傷

Abstract

Middle ear barotrauma is a major side effect of hyperbaric oxygenation therapy (OHP) which may develop such clinical symptoms as otalgia and ear fullness.The purpose of this study is to observe patients with side effects during OHP and examine the factors predisposing to middle ear barotrauma.OHP was used in 94 patients (64 males and 30 females) at Shakaihoken Takaoka Hospital. Their subjective symptoms were correlated with sex, age, primary diseases and the incidence of middle ear barotrauma.In 12 patients with middle ear barotrauma, the incidence of eustachian tube stenosis, and of nasal and paranasal diseases were determined. Eustachian tube stenosis was evaluated by the measurement of opening pressure by catheter inflation. Nasal and paranasal diseases were evaluated by anterior rhinoscopy and plain X-rays.1. The incidence of middle ear barotrauma was 37.2%, higher in males (45.3%) than in females (20.0%).2. Aged patients and those with severe disease had a low incidence of middle ear barotrauma, but some of them might not have mentioned symptoms.3. In patients with middle ear barotrauma, a high incidence of nasal and paranasal diseases and a low incidence of eustachian tube stenosis were observed.These results suggest that otorhinolaryngological examinations should be performed in all patients treated with OHP. Treatment of nasal and paranasal diseases is important to prevent middle ear barotrauma.