Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Grenoble-Alpes, BP 217, 38043, Grenoble Cedex 09, France.
GeodAIsics, Grenoble, France.
Eur Arch Otorhinolaryngol. 2024 Aug;281(8):4057-4061. doi: 10.1007/s00405-024-08544-w. Epub 2024 Mar 12.
To discuss the link between inner ear decompression sickness and patent foramen ovale.
Monocentric and retrospective study on decompression sickness of the inner ear requiring hyperbaric chamber treatment, from 2014 to 2021.
Sixty-one patients of inner ear decompression sickness were included in this study. Twenty-four patients had vestibular injuries, 28 cochlear injuries and 9 cochleo-vestibular injuries. Compression chamber treatment was given, using an oxygen-helium mixture with oxygen partial pressure (PIO2) limited to 2.8 atmosphere absolute (ATA). All vestibular accidents completely recovered without clinical sequelae. For cochlear accident only 10 out of 37 patients (27%) recovered completely. A right-left shunt (patent foramen oval or intra-pulmonary shunt) was found in 31.1% of patients with inner ear decompression sickness (p > 0.05).
The presence of patent foramen oval in patients with inner ear decompression was not statistically significant in our study. Understanding of the pathophysiology of decompression illness and the physiology and anatomy of the labyrinth would suggest a mechanism of supersaturation with degassing in intra-labyrinthine liquids.
探讨内耳减压病与卵圆孔未闭的关系。
对 2014 年至 2021 年需要高压氧舱治疗的内耳减压病进行单中心回顾性研究。
本研究共纳入 61 例内耳减压病患者。24 例有前庭损伤，28 例有耳蜗损伤，9 例有耳蜗-前庭损伤。使用氧氦混合气进行压缩室治疗，氧分压（PIO2）限制在 2.8 绝对大气压（ATA）以下。所有前庭意外均完全恢复，无临床后遗症。对于耳蜗意外，只有 37 例患者中的 10 例（27%）完全恢复。内耳减压病患者中发现右向左分流（卵圆孔未闭或肺内分流）占 31.1%（p>0.05）。
在我们的研究中，内耳减压病患者卵圆孔未闭的存在无统计学意义。对减压病的病理生理学以及迷路的生理学和解剖学的理解表明，在内耳液体中存在过饱和和脱气的机制。
