Blanshard J, Toma A, Bryson P, Williamson P
Department of Otolaryngology, Derriford Hospital, Plymouth, UK.
Clin Otolaryngol Allied Sci. 1996 Oct;21(5):400-3. doi: 10.1046/j.1365-2273.1996.00813.x.
Hyperbaric oxygen therapy is associated with a risk of barotrauma to the middle ear. This prospective study of 82 patients undergoing long-term therapy for chronic conditions was designed to measure the incidence and severity of middle ear barotrauma. Twenty-four patients (29.3%) required the insertion of ventilation tubes for otalgia, significantly more of whom were suffering from radionecrosis of the head and neck region (P < 0.01). Thirty-two of the remaining 58 patients (55%) underwent specialist ENT assessment by otoscopy and tympanometry. Five ears (8%) showed the otoscopic changes of barotrauma (TEED grade 3 or 4), and one ear (2%) showed tympanometric evidence of a middle ear effusion (Type B tympanogram). We conclude that despite careful tuition in pressure equalization and the appropriate use of ventilation tubes, up to 8% of ears sustain significant barotrauma. Tympanometry is unreliable in detecting these changes, otoscopy provides the most reliable screening technique.
高压氧治疗存在中耳气压伤的风险。这项对82例接受慢性病长期治疗患者的前瞻性研究旨在测量中耳气压伤的发生率和严重程度。24例患者（29.3%）因耳痛需要插入通气管，其中患有头颈部放射性坏死的患者明显更多（P<0.01）。其余58例患者中的32例（55%）接受了耳鼻喉科专家通过耳镜检查和鼓室压测量进行的评估。5只耳朵（8%）显示出气压伤的耳镜检查变化（TEED 3级或4级），1只耳朵（2%）显示出中耳积液的鼓室压测量证据（B型鼓室图）。我们得出结论，尽管在压力平衡方面进行了仔细指导并适当使用了通气管，但仍有高达8%的耳朵遭受严重气压伤。鼓室压测量在检测这些变化方面不可靠，耳镜检查是最可靠的筛查技术。
