Strutz J
Universitäts-HNO-Klinik, Freiburg.
HNO. 1988 May;36(5):198-205.
Ear diseases are the most common of all occupational diseases of diving. Otitis externa is the most frequent and troublesome infection in divers especially when the environment is humid. During compression, failure to equalize the pressure of the air-filled cavities surrounded by bone (middle ear, sinus) deprives the middle ear (or sinus) of aeration. Middle ear barotrauma is the most common barotrauma encountered in divers while external ear barotrauma (reversed ear) and inner ear barotrauma (with rupture of the round or oval window) are less common. Decompression sickness (Caisson disease) is primarily the result of inert gas bubbles; deafness and vertigo may result if the inner ear is involved. The most dramatic cause of disorientation under water is that due to vertigo. This vertigo is commonly a transient effect due to unequal caloric stimulation of the two labyrinths. The physical examination of the ear and nose necessary for assessment of diving fitness are discussed. A list of ENT contra-indications is presented which mandate temporary or permanent disqualification from diving.
耳部疾病是潜水所有职业病中最常见的。外耳道炎是潜水员中最常见且麻烦的感染，尤其是在环境潮湿时。在加压过程中，未能平衡被骨质包围的含气腔（中耳、鼻窦）的压力会使中耳（或鼻窦）无法通气。中耳气压伤是潜水员中最常见的气压伤，而外耳气压伤（反向耳）和内耳气压伤（圆窗或卵圆窗破裂）则较少见。减压病（沉箱病）主要是惰性气泡的结果；如果内耳受累，可能会导致耳聋和眩晕。水下最严重的定向障碍原因是眩晕。这种眩晕通常是由于两个迷路的热刺激不均引起的短暂效应。讨论了评估潜水适宜性所需的耳部和鼻部体格检查。列出了耳鼻喉科的禁忌症，这些禁忌症要求暂时或永久取消潜水资格。
