PMID- 37718299 OWN - NLM STAT- MEDLINE DCOM- 20230919 LR - 20231223 IS - 1833-3516 (Print) IS - 2209-1491 (Electronic) IS - 1833-3516 (Linking) VI - 53 IP - 3 DP - 2023 Sep 30 TI - A retrospective review of divers treated for inner ear decompression sickness at Fiona Stanley Hospital hyperbaric medicine unit 2014-2020. PG - 243-250 LID - 10.28920/dhm53.3.243-250 [doi] AB - INTRODUCTION: Inner ear decompression sickness (IEDCS) is increasingly recognised in recreational diving, with the inner ear particularly vulnerable to decompression sickness in divers with a right-to-left shunt, such as is possible through a persistent (patent) foramen ovale (PFO). A review of patients treated for IEDCS at Fiona Stanley Hospital Hyperbaric Medicine Unit (FSH HMU) in Western Australia was performed to examine the epidemiology, risk factors for developing this condition, the treatment administered and the outcomes of this patient population. METHODS: A retrospective review of all divers treated for IEDCS from the opening of the FSH HMU on 17 November 2014 to 31 December 2020 was performed. Patients were included if presenting with vestibular or cochlear dysfunction within 24 hours of surfacing from a dive, and excluded if demonstrating features of inner ear barotrauma. RESULTS: There were a total of 23 IEDCS patients and 24 cases of IEDCS included for analysis, with 88% experiencing vestibular manifestations and 38% cochlear. Median dive time was 40 minutes and median maximum depth was 24.5 metres. The median time from surfacing to hyperbaric oxygen treatment (HBOT) was 22 hours. Vestibulocochlear symptoms fully resolved in 67% and complete symptom recovery was achieved in 58%. A PFO was found in 6 of 10 patients who subsequently underwent investigation with bubble contrast echocardiography upon follow-up. CONCLUSIONS: IEDCS occurred predominantly after non-technical repetitive air dives and ongoing symptoms and signs were often observed after HBOT. Appropriate follow-up is required given the high prevalence of PFO in these patients. CI - Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms. FAU - Mason, Jeremy S AU - Mason JS AD - Department of Hyperbaric Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia. AD - Corresponding author: Dr Jeremy Mason, Department of Hyperbaric Medicine, Fiona Stanley Hospital, 11 Robin Warren Drive, Murdoch, WA, 6150, Australia, jeremy.mason@health.wa.gov.au. FAU - Buzzacott, Peter AU - Buzzacott P AD - Prehospital, Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, WA, Australia. FAU - Gawthrope, Ian C AU - Gawthrope IC AD - Department of Hyperbaric Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia. AD - University of Notre Dame, Fremantle, WA, Australia. FAU - Banham, Neil D AU - Banham ND AD - Department of Hyperbaric Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia. LA - eng PT - Journal Article PL - Australia TA - Diving Hyperb Med JT - Diving and hyperbaric medicine JID - 101282742 RN - 9002-68-0 (Follicle Stimulating Hormone) RN - S88TT14065 (Oxygen) SB - IM MH - Humans MH - *Decompression Sickness/epidemiology/therapy MH - *Ear, Inner MH - Follicle Stimulating Hormone MH - Hospitals MH - *Hyperbaric Oxygenation MH - Oxygen MH - Retrospective Studies PMC - PMC10735645 OTO - NOTNLM OT - Diving medicine OT - Diving research OT - ENT OT - Hyperbaric oxygen OT - Persistent (patent) foramen ovale (PFO) OT - Right-to-left shunt OT - Vertigo COIS- Conflict of interest and funding: nil EDAT- 2023/09/18 00:41 MHDA- 2023/09/19 06:42 PMCR- 2024/09/30 CRDT- 2023/09/17 22:53 PHST- 2022/05/21 00:00 [received] PHST- 2023/05/21 00:00 [accepted] PHST- 2024/09/30 00:00 [pmc-release] PHST- 2023/09/19 06:42 [medline] PHST- 2023/09/18 00:41 [pubmed] PHST- 2023/09/17 22:53 [entrez] AID - 10.28920/dhm53.3.243-250 [doi] PST - ppublish SO - Diving Hyperb Med. 2023 Sep 30;53(3):243-250. doi: 10.28920/dhm53.3.243-250.