Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London, England.
Duke Skull Base Center, Duke University School of Medicine, Durham, North Carolina.
JAMA Otolaryngol Head Neck Surg. 2018 Mar 1;144(3):252-258. doi: 10.1001/jamaoto.2017.2617.
Scuba diving is becoming increasingly popular. However, scuba diving is associated with specific risks; 80% of adults and 85% of juvenile divers (aged 6-17 years) have been reputed to have an ear, nose, or throat complaint related to diving at some point during their diving career. Divers frequently seek advice from primary care physicians, diving physicians, and otorhinolaryngologists, not only in the acute setting, but also related to the long-term effects of diving.
The principles underpinning diving-related injuries that may present to the otorhinolaryngologist rely on gas volume and gas saturation laws, and the prevention of these injuries requires both that the diver is skilled and that their anatomy allows for pressure equalization between the various anatomical compartments. The overlapping symptoms of middle ear barotrauma, inner ear barotrauma, and inner ear decompression sickness can cause a diagnostic conundrum, and a thorough history of both the diver's symptoms and the dive itself are required to elucidate the diagnosis. Correct diagnosis and appropriate treatment result in a more timely return to safe diving.
The aim of this review is to provide a comprehensive overview of otorhinolaryngological complications during diving. With the increasing popularity of diving and the frequency of ear, nose, or throat-related injuries, it could be expected that these injuries will become more common and this review provides a resource for otorhinolaryngologists to diagnose and treat these conditions.
潜水运动越来越受欢迎。然而,潜水运动与特定的风险相关联;80%的成年人和 85%的青少年潜水员(6-17 岁)在其潜水生涯的某个阶段曾因潜水而出现过与耳朵、鼻子或喉咙相关的抱怨。潜水员经常向初级保健医生、潜水医生和耳鼻喉科医生寻求建议,不仅是在急性情况下,还与潜水的长期影响有关。
可能会向耳鼻喉科医生报告的与潜水相关的受伤的基本原则依赖于气体体积和气体饱和定律,预防这些伤害既需要潜水员具备技能,又需要他们的解剖结构允许各个解剖部位之间的压力平衡。中耳气压伤、内耳气压伤和内耳减压病的重叠症状可能会导致诊断难题,需要详细了解潜水员的症状和潜水本身,以阐明诊断。正确的诊断和适当的治疗可以更快地恢复安全潜水。
本综述的目的是全面概述潜水期间耳鼻喉科并发症。随着潜水运动的普及和与耳朵、鼻子或喉咙相关的受伤频率的增加,可以预期这些受伤会变得更加常见,而本综述为耳鼻喉科医生诊断和治疗这些疾病提供了资源。