Cases reported "Barotrauma"

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1/7. Inner ear barotrauma from scuba diving.

    Inner ear barotrauma among scuba divers is believed to be caused by any of three conditions: a hemorrhage in the inner ear, a tear of the labyrinthine membrane, or a perilymphatic fistula. These injuries may occur concurrently or separately. hemorrhage and membrane rupture are managed conservatively, while fistula requires surgical repair. In this report, we describe three cases of inner ear barotrauma in scuba divers. We also discuss the proposed etiologies of this injury and the controversy over whether or not divers who have suffered an inner ear trauma can safely resume scuba diving. Although the older literature clearly suggests otherwise, we believe that scuba divers who completely recover from inner (or middle) ear barotrauma may return to diving as long as they exercise caution and care.
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keywords = perilymphatic
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2/7. A case of barotrauma-induced pneumolabyrinth secondary to perilymphatic fistula.

    We report the case of a 62-year-old woman who experienced pneumolabyrinth associated with a perilymphatic fistula. Her condition was diagnosed with the help of computed tomography, which detected the presence of an air bubble in the labyrinth, and middle ear exploration, which revealed that clear fluid was emanating from the round window niche in a manner consistent with the presence of a perilymphatic fistula. The niche was repaired with tragal perichondrium and bolstered with Gelfoam.
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ranking = 6
keywords = perilymphatic
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3/7. Sensorineural hearing loss as the result of cliff jumping.

    A case of unilateral, sudden sensorineural hearing loss and possible perilymphatic fistula as the result of cliff jumping into water is presented. The physiological mechanisms contributing to such a barotraumatic auditory injury are described. A conservative treatment protocol is reviewed as well as documented hearing recovery.
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ranking = 1
keywords = perilymphatic
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4/7. Hearing preservation in perilymphatic fistula due to a congenital fistula in an adult.

    Congenital fistula in the stapedial footplate usually can be diagnosed by the recurrence of meningitis caused by spontaneous cerebrospinal fluid (CSF) in infants or young children. We report the case of a 65-year-old woman, who was initially diagnosed as having an acquired perilymphatic fistula caused by aural barotrauma and demonstrated episodic vertigo and fluctuant sensorineural hearing loss in the right ear after air travel. Surgical exploration showed a congenital circular defect in the peripheral part of the stapedial footplate with leakage of CSF. The fistula was closed by inserting a tiny piece of fascia attached to both the tympanic and perilymphatic side of the stapedial footplate utilizing the back-pressure of perilymphatic fluid and fibrin glue; hearing was preserved.
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ranking = 7
keywords = perilymphatic
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5/7. Perilymphatic fistula induced by barotrauma.

    The association between diving, barotrauma, and the production of perilymphatic fistula has been known for almost 20 years. Forty-eight cases of round and oval window fistulas following diving have been reviewed and essentially corroborate previous findings. Any patient with a history of diving and subsequent sensorineural hearing loss within 72 hours should be suspected of having a round or oval window perilymphatic fistula and surgical exploration and closure of the fistula should be undertaken. patients who have a loss of hearing, vertigo, nausea, or vomiting following a decompression dive should be re-compressed and if symptoms do not clear, exploration should be performed. Surgical treatment should be executed as soon as possible after the diagnosis is suspected for the best possible results.
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ranking = 2
keywords = perilymphatic
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6/7. tinnitus in an active duty navy diver: A review of inner ear barotrauma, tinnitus, and its treatment.

    This case elucidates subtle cues that must be appreciated by the examiner in diving related injuries, who may not have experience with barotrauma-mediated pathology. Inner-ear barotrauma (IEBT) does not mandate ostensible hearing loss or vertigo; tinnitus may be the sole manifestation. Symptoms may present hours or even days post-dive. A common misconception exists that there are no efficacious treatment options for IEBT short of surgery for an overt perilymphatic fistula. Treatment options are available including acute high dose steroid administration, as prescribed for acute noise-induced or idiopathic hearing loss, optimally administered within three weeks of the acute insult. tinnitus does not necessarily constitute a chronic untreatable symptom, which the patient must learn "to live with".
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ranking = 1
keywords = perilymphatic
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7/7. Spontaneous perilymphatic fistula: electrophysiologic findings in animals and man.

    The case against the occurrence of spontaneous perilymphatic fistulas is presented. Electrophysiologic findings both in animals and in man suggest that small holes in either the round or oval window are not associated with any significant hearing loss. Removal of perilymph may cause some changes in the electrocochleogram that can be reversed when the perilymph is replaced. Tympanotomy surgery, especially when performed with the injection of local anesthetic solutions may result in transudates in the middle ear that are difficult to differentiate from perilymph leaking out from the inner ear. Perilymphatic fistulas were excluded by performing a posterior myringotomy under general anesthesia in 162 congenitally deaf ears. If fluid was present it was suctioned, and if no change occurred on the intraoperative electrocochleogram, it was concluded that no fistula existed. Based on the electrophysiologic findings and the clinical observations in over 240 ears, it was concluded that spontaneous perilymphatic fistulas do not exist. The author accepts that perilymphatic fistulas occur after surgery, especially after stapedectomy, and that they can occur after head injury or barotrauma. However, these should heal readily; persistent or intermittent fistulas are an otologic rarity.
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ranking = 7
keywords = perilymphatic
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