Kitajima Naoharu, Sugita-Kitajima Akemi, Kitajima Seiji
Kitajima ENT Clinic
Nihon Jibiinkoka Gakkai Kaiho. 2012 Dec;115(12):1029-36. doi: 10.3950/jibiinkoka.115.1029.
The scuba diving population has increased very much recently, bringing with it a rise in barotrauma. Ninety-seven patients with scuba diving-related accidents (34 males and 63 females; mean +/- SD: 36.6 +/- 10.3 years) and 39 healthy volunteers (9 males and 30 females; mean +/- SD: 41.1 +/- 16.9 years) without a history of Eustachian tube dysfunction participated in this study. All patients underwent audiometric measurements, including hearing testing, tympanometry, and Eustachian tube function testing (sonotubometry and impedance test). The tympanometry results of the majority of the patients were normal (Jerger A type), however, 83 of 97 patients (85.6%) were diagnosed as having Eustachian tube dysfunction: all patients had tubal stenosis. Compared with healthy volunteers, the Eustachian tube function in scuba diving patients was significantly lower. According to whether the affected parts were one ear or both ears, we classified these patients into 2 types, that is, the unilateral group and the bilateral group. The symptoms in the unilateral group were more serious than those in the bilateral group. In the unilateral group, the Eustachian tube functions of the affected ear did not always show lower than those of the healthy ear, so we thought that excessive positive pressure at the mesotympanum caused by the Valsalva maneuver might have affected not only the affected ear but also the healthy ear and have resulted in healthy ears being severely impaired by excessive positive pressure. To prevent scuba divers from pressure injury, we think that divers should have their Eustachian tube dysfunction accurately evaluated and any problems should be treated well.
最近,水肺潜水人群数量大幅增加,随之而来的是气压伤病例的增多。97例与水肺潜水相关事故的患者(34例男性和63例女性;平均±标准差:36.6±10.3岁)和39名无咽鼓管功能障碍病史的健康志愿者(9例男性和30例女性;平均±标准差:41.1±16.9岁)参与了本研究。所有患者均接受了听力测定,包括听力测试、鼓室图检查和咽鼓管功能测试(声导管测量法和阻抗测试)。大多数患者的鼓室图结果正常(耶格A型),然而,97例患者中有83例(85.6%)被诊断为咽鼓管功能障碍:所有患者均存在咽鼓管狭窄。与健康志愿者相比,水肺潜水患者的咽鼓管功能明显更低。根据受影响的是一只耳朵还是两只耳朵,我们将这些患者分为2种类型,即单侧组和双侧组。单侧组的症状比双侧组更严重。在单侧组中,患耳的咽鼓管功能并不总是低于健康耳,因此我们认为瓦尔萨尔瓦动作引起的中耳过度正压可能不仅影响患耳,还影响健康耳,并导致健康耳因过度正压而严重受损。为防止水肺潜水者受到压力损伤,我们认为潜水者应准确评估其咽鼓管功能障碍,并妥善处理任何问题。