[潜水前检查中评估乳突气化的预测价值]

[The predictive value of assessing mastoid pneumatization in pre-dive examinations].

作者信息

Uzun Cem, Taş Abdullah, Yağiz Recep, Adali Mustafa K, Koten Muhsin, San Haldun, Karasalihoğlu Ahmet R

机构信息

Department of Otolaryngology, Medicine Faculty of Trakya University, Edirne, Turkey.

出版信息

Kulak Burun Bogaz Ihtis Derg. 2005;15(3-4):56-61.

PMID:16340294

Abstract

OBJECTIVES

We investigated the value of assessing the degree of mastoid pneumatization in predicting middle ear barotrauma -the most common problem in sport SCUBA divers- in comparison with that of the conventional pre-dive examination method, the Valsalva maneuver.

MATERIALS AND METHODS

Thirty-four volunteer sport SCUBA divers having normal pre-dive examination findings were included. The Valsalva test was performed in all the divers. Mastoid pneumatization for each ear was calculated on a Schuller's view radiography. Pneumatization of = or <30 cm2 was accepted as poor (prone to barotrauma) and >30 cm2 was accepted as good (not prone to barotrauma). During the observation period, the divers were monitored with regard to barotrauma symptoms and signs.

RESULTS

The degree of mastoid pneumatization was = or <30 cm2 in 26 ears (38%) of 16 divers (47%). The Valsalva test was negative in eight ears (12%) of six divers (18%). During a total of 1001 dives, symptomatic middle ear barotrauma occurred in 28 dives (2.8%), i.e. in 21 ears (31%) of 16 divers (47%). Of these, the degree of mastoid pneumatization predicted barotrauma in 11 (69%) divers, whereas the Valsalva test was negative in only three (19%) (p<0.05), with sensitivity, specificity, positive and negative predictive values, and efficiency being 69% and 19%, 72% and 83%, 69% and 50%, 72% and 54%, and 71% and 53%, respectively.

CONCLUSION

The value of assessing mastoid pneumatization in predicting middle ear barotrauma in sport SCUBA divers is higher than that of the Valsalva test.

摘要

目的

我们研究了评估乳突气化程度在预测中耳气压伤（这是运动潜水员中最常见的问题）方面的价值，并与传统的潜水前检查方法瓦尔萨尔瓦动作进行比较。

材料与方法

纳入34名潜水前检查结果正常的志愿运动潜水员。所有潜水员均进行了瓦尔萨尔瓦试验。通过许勒位X线片计算每只耳朵的乳突气化程度。乳突气化面积≤或<30平方厘米被认为较差（易发生气压伤），>30平方厘米被认为良好（不易发生气压伤）。在观察期内，对潜水员的气压伤症状和体征进行监测。

结果

16名潜水员（47%）的26只耳朵（38%）乳突气化程度≤或<30平方厘米。6名潜水员（18%）的8只耳朵（12%）瓦尔萨尔瓦试验结果为阴性。在总共1001次潜水中，有28次潜水（2.8%）出现了有症状的中耳气压伤，即16名潜水员（47%）的21只耳朵（31%）出现了症状。其中，乳突气化程度预测了11名（69%）潜水员的气压伤，而瓦尔萨尔瓦试验仅在3名（19%）潜水员中结果为阴性（p<0.05），其敏感性、特异性、阳性和阴性预测值以及效率分别为69%和19%、72%和83%、69%和50%、72%和54%、71%和53%。