Sudden hearing loss in divers and fliers.

Many papers have been written about sudden sensory hearing loss and the effect of barotrauma on the inner ear. Fistulae of the round and oval window membranes have been implicated in the great majority of these cases. It has usually been recommended that the patient be treated with conservative therapy, such as bed rest, for a period of as long as 30 days and that the final hearing results are as good or better than those that have been surgically explored and corrected. In our experience immediate surgical exploration and correction of sudden severe or profound sensorineural deafness in the diver or flier is absolutely essential and the excellent results of hearing improvement in this select group certainly corroborates this theory. Other cases with the hearing loss limited to the high frequencies most notably have tinnitus and surgical exploration does not improve the hearing but may improve vertigo if present. Numerous cases are presented to support these supositions.