Lamprell Laura, Young Derelle, Vangaveti Venkat, Orton John, Suruliraj Anand
Department of Otolaryngology Head and Neck Surgery, The Townsville Hospital, 100 Angus Smith Drive, Douglas, Queensland 4814, Australia, Phone: +61-(0)7-4433-1111, Email:
Hyperbaric Medicine Unit, The Townsville Hospital, Queensland.
Diving Hyperb Med. 2014 Sep;44(3):137-40.
One significant side effect of hyperbaric oxygen treatment (HBOT) is middle ear barotrauma (MEBT) may require tympanostomy tube (grommet) insertion by the Ear, Nose and Throat service. Where timely HBOT is needed, routine insertion of grommets under local anaesthesia (LA) is becoming common.
To investigate the differences between patients receiving HBOT and concurrent grommets under LA versus general anesthesia (GA) at The Townsville Hospital (TTH).
A retrospective chart analysis of patients receiving HBOT between 2008 and 2012 and requiring grommets was undertaken.
Thirty-one (5%) out of 685 patients treated with HBOT from 2008 to 2012 received grommets. Twelve cases received grommets under LA, and 19 under GA. Twenty out of the 31 cases had grommets following MEBT and the remainder prophylactically. Complications of grommet insertion comprised two cases with blocked grommets. There was a significant difference (P = 0.005) in the time in days from ENT referral to HBOT between the LA group (median 1 day, range 0-13 days) and the GA group (median 8 days, range 0-98 days).
A greater number of hyperbaric patients received grommets under GA than LA at the TTH. Insertion of grommets under LA was safe, offering advantages to both the patient and the treating team in the setting of HBOT-associated otic barotrauma.
高压氧治疗（HBOT）的一个显著副作用是中耳气压伤（MEBT），可能需要耳鼻喉科进行鼓膜造孔管（通气管）插入术。在需要及时进行HBOT的情况下，在局部麻醉（LA）下常规插入通气管正变得越来越普遍。
研究汤斯维尔医院（TTH）接受HBOT并同时在局部麻醉与全身麻醉（GA）下插入通气管的患者之间的差异。
对2008年至2012年期间接受HBOT且需要插入通气管的患者进行回顾性病历分析。
2008年至2012年接受HBOT治疗的685例患者中，有31例（5%）接受了通气管插入术。12例在局部麻醉下插入通气管，19例在全身麻醉下插入。31例中有20例在中耳气压伤后插入通气管，其余为预防性插入。通气管插入的并发症包括2例通气管堵塞。局部麻醉组（中位时间1天，范围0 - 13天）和全身麻醉组（中位时间8天，范围0 - 98天）从耳鼻喉科转诊到进行HBOT的天数存在显著差异（P = 0.005）。
在汤斯维尔医院，接受全身麻醉插入通气管的高压氧治疗患者比接受局部麻醉的患者更多。在局部麻醉下插入通气管是安全的，在与HBOT相关的耳气压伤情况下，对患者和治疗团队都有好处。
