Lindfors Oskari H, Lundell Richard V, Arola Olli J, Hirvonen Timo P, Sinkkonen Saku T, Räisänen-Sokolowski Anne K
Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Defence Command and Diving Medical Centre, Finnish Defence Forces, Helsinki, Finland.
Undersea Hyperb Med. 2021 Fourth Quarter;48(4):399-408.
Inner ear decompression sickness (IEDCS) is a condition from which only a minority of patients recover completely, the majority ending up with mild to moderate residual symptoms. IEDCS has been reported after deep technical dives using mixed breathing gases, and moderate recreational dives with compressed air as the breathing gas. Considering this and the high proportion of technical diving in Finland, a comparison between IEDCS cases resulting from technical and recreational dives is warranted.
This is a retrospective examination of IEDCS patients treated at Hyperbaric Center Medioxygen or National Hyperbaric Centre of Turku University Hospital from 1999 to 2018. Patients were included if presenting with hearing loss, tinnitus, or vertigo and excluded if presenting only with symptoms of middle ear or cerebellar involvement. Patients were divided into technical and recreational divers, based on incident dive.
A total of 89 (15.6%) of all DCS patients presented with IEDCS, two-thirds treated during the latter decade. The most common predisposing factors were consecutive days of diving (47.2%), multiple dives per day (53.9%), and factors related to an increase in intrathoracic pressure (27.0%). The symptoms were cochlear in 19.1% and vestibular in 93.3% of cases, symptoms being more common and severe in technical divers. Complete recovery was achieved in 64.5% of technical and 71.4% of recreational divers.
The incidence of IEDCS in Finland is increasing, most likely due to changing diving practices. A comprehensive examination should be carried out after an incident of IEDCS in all cases, irrespective of clinical recovery.
内耳减压病（IEDCS）是一种只有少数患者能完全康复的疾病，大多数患者最终会遗留轻度至中度的症状。在使用混合呼吸气体进行深度技术潜水以及以压缩空气为呼吸气体进行中度休闲潜水后，都有内耳减压病的报告。考虑到这一点以及芬兰技术潜水的高比例，对技术潜水和休闲潜水导致的内耳减压病病例进行比较是有必要的。
这是一项对1999年至2018年在Medioxygen高压氧中心或图尔库大学医院国家高压氧中心接受治疗的内耳减压病患者的回顾性研究。出现听力损失、耳鸣或眩晕的患者被纳入研究，仅表现为中耳或小脑受累症状的患者被排除。根据潜水事件，将患者分为技术潜水员和休闲潜水员。
所有减压病患者中有89例（15.6%）患有内耳减压病，其中三分之二是在最近十年接受治疗的。最常见的诱发因素是连续潜水天数（47.2%）、每天多次潜水（53.9%）以及与胸腔内压力增加相关的因素（27.0%）。19.1%的病例症状为耳蜗性，93.3%为前庭性，技术潜水员的症状更常见且更严重。64.5%的技术潜水员和71.4%的休闲潜水员实现了完全康复。
芬兰内耳减压病的发病率正在上升，很可能是由于潜水方式的改变。在所有内耳减压病事件发生后，无论临床是否康复，都应进行全面检查。
