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OTITIC BAROTRAUMA:
SEROUS EFFUSION
People with normal eustachian tube function generally do not
experience difficulty in coping with gradual pressure changes.
Problems arise when either the eustachian tube function is
impaired or when the pressure change is rapid or too great for
the capacity of the eustachian and are most likely to develop in
those individuals who have impaired eustachian tube function.
The most common cause of eustachian tube failure in patients
who develop otitic barotrauma is usually an upper respiratory
infection.
BAROTRAUMA:
SEROUS EFFUSION
Otitic barotrauma can also develop in patients undergoing hyperbaric oxygen
therapy in a decompression chamber
The damage in otitic barotrauma occurs as the tympanic membrane is
displaced medially by the increased surrounding atmospheric pressure. There
is a splinting and loss of the mobility of the tympanic membrane and the
inward stretching causes pain. In some cases linear inters hemorrhages may
develop within the drum, most c monly in the pars flaccida.The relative
negative pressre within the middle ear can cause hyperemia, ecchymosis and
edema of the middle ear mucosa resulting in the transudation of a thin,
golden yellow serous fluid. Less commonly, the mucosal blood vessels may
rupture, causing a frank hemorrhage into the middle ear cleft
(hemotympamum). Unlike chronic effusions, this acute transudative process is
typically associated with a severe earache due to the speed of the pressure
change.
OTITIC BAROTRAUMA:
INTERSTITIAL HEMHORRAGE
Extreme pressure changes may disrupt the
oval or round window seals, causing the
leakage of perilymph into middle ear. The
presence of vertigo or a fluctuating
sensorineural hearing loss are worrisome
symptoms suggestive of a perilymph fistula.
This is an otologic emergency which can be
confirmed and treated only by surgical
exploration of the middle ear.
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