Abstract
IntroductionThe Frenzel maneuver describes a technique for middle ear equalizing which is frequently used by apnea divers. It offers advantages compared to the most commonly used techniques such as the Valsalva or Toynbee maneuver. Until now, there is insufficient literature about the pressure dynamics and Eustachian tube (ET) function during the Frenzel maneuver. The aim of the present study was to characterize the ET function during the Frenzel maneuver.Materials and methodsBy means of an established standardized profile of compression and decompression in a hypo/hyperbaric pressure chamber, we examined different parameters such as the ET opening pressure (ETOP), ET opening duration (ETOD), and ET opening frequency (ETOF) in 11 experienced apnea divers and compared them to the parameters during the Valsalva and Toynbee maneuver.ResultsStandard values for ETOP, ETOD, and ETOF could be established for the Frenzel maneuver under standardized conditions in a hypo/hyperbaric pressure chamber. Compared to the Frenzel maneuver, ETOP was higher and ETOD longer (both p < 0.001) during the Valsalva maneuver whereas ETOP was lower and ETOD shorter (both p < 0.001) during the Toynbee maneuver. No difference regarding ETOF was observed between the Frenzel, Valsalva, and Toynbee maneuver.DiscussionThe Frenzel maneuver was shown to be at least as effective as the Valsalva maneuver concerning ET opening. We believe that knowledge of the Frenzel technique might facilitate the pressure equalization during diving and recommend implementation of an appropriate equalization training in apnea and scuba diving education.
Highlights
The Frenzel maneuver describes a technique for middle ear equalizing which is frequently used by apnea divers
While the pressure in the Valsalva maneuver is increased by increasing the intrapulmonary pressure while having the mouth and nose closed at the same time, in the Frenzel maneuver, only the pressure in the nose and nasopharynx is increased by closing the soft palate
It was assumed that both ET opening pressure (ETOP) and ET opening duration (ETOD) should be similar when performing the Valsalva maneuver compared to the Frenzel
Summary
The Frenzel maneuver describes a technique for middle ear equalizing which is frequently used by apnea divers. It offers advantages compared to the most commonly used techniques such as the Valsalva or Toynbee maneuver. Materials and methods By means of an established standardized profile of compression and decompression in a hypo/hyperbaric pressure chamber, we examined different parameters such as the ET opening pressure (ETOP), ET opening duration (ETOD), and ET opening frequency (ETOF) in 11 experienced apnea divers and compared them to the parameters during the Valsalva and Toynbee maneuver. European Archives of Oto-Rhino-Laryngology ovale, use of the Valsalva technique might cause a significant right–left shunt in the atrium [2] Another commonly used technique is the Toynbee maneuver. This method requires voluntary control of tensor veli palatine muscles, which leads to opening of the ET [7]
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