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持续气道正压通气导致的耳气压伤:病例报告及文献综述

Otic Barotrauma Resulting from Continuous Positive Airway Pressure: Case Report and Literature Review.

作者信息

McCormick Justin P, Hildrew Douglas M, Lawlor Claire M, Guittard Jesse A, Worley N Knight

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of South Alabama College of Medicine, Mobile, AL.

Department of Otolaryngology - Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA.

出版信息

Ochsner J. 2016 Summer;16(2):146-9.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) is a growing problem affecting millions of people in the United States. The prevalence of OSA has risen drastically in the past few decades concurrently with the increasing prevalence of obesity. Subsequently, there has been an ever-increasing rise in the use of continuous positive airway pressure (CPAP) devices. While using CPAP devices may lead to many adverse effects, the majority of these effects are described as relatively benign.

CASE REPORT

We describe the detailed clinical course and outcome for a patient with otic barotrauma as a result of excessive self-titration of CPAP therapy in an in-home setting. We also discuss the pathophysiology of otic barotrauma and present a review of current literature on the topic.

CONCLUSION

While the benefits of CPAP are clear, we must take into account the rare but possible effects on ear structure and function. Many studies describe an increase in middle ear pressure with the use of CPAP, but few describe the effects of this increased pressure on the middle ear, such as the otic barotrauma described in this case. Given the increased prevalence of OSA, it is important to understand the risks associated with CPAP therapy.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)是一个日益严重的问题,影响着美国数百万人。在过去几十年中,OSA的患病率随着肥胖患病率的上升而急剧上升。随后,持续气道正压通气(CPAP)设备的使用也在不断增加。虽然使用CPAP设备可能会导致许多不良反应,但这些反应大多被描述为相对良性。

病例报告

我们描述了一名患者在家庭环境中因过度自行调整CPAP治疗而导致耳气压伤的详细临床过程和结果。我们还讨论了耳气压伤的病理生理学,并对该主题的当前文献进行了综述。

结论

虽然CPAP的益处显而易见,但我们必须考虑到其对耳部结构和功能的罕见但可能的影响。许多研究描述了使用CPAP时中耳压力的增加,但很少描述这种压力增加对中耳的影响,如本病例中所述的耳气压伤。鉴于OSA患病率的增加,了解与CPAP治疗相关的风险非常重要。

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