Taravana, vestibular decompression illness, and autochthonous distal arterial bubbles

Abstract

Decompression bubbles can develop only from pre-existing gas micronuclei. These are the nanobubbles which appear on active hydrophobic spots (AHS) found on the luminal aspect of all blood vessels. Following decompression, with the propagation of blood along the arterial tree, diffusion parameters cause increased transfer of nitrogen from the tissue into the artery, and more so if perfusion is low. Taravana is a neurological form of decompression illness (DCI) prevalent in repeated breath-hold diving. A nanobubble on an AHS in a distal artery of the brain may receive an influx of nitrogen after each dive until it occludes the arterial blood flow. The vestibular organ has very low perfusion compared with the brain and the cochlea of the inner ear. We suggest that a nanobbubble on an AHS in the distal artery of the vestibular organ will receive a high influx of nitrogen from the surrounding tissue after decompression due to the low nitrogen clearance, thus expanding to cause vestibular DCI.