[abstract] COMPARISON OF SIGNIFICANT OTIC BAROTRAUMA BASED ON DEPTH OF DIVE AND INDICATION FOR HYPERBARIC OXYGEN TREATMENT

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[abstract] COMPARISON OF SIGNIFICANT OTIC BAROTRAUMA BASED ON DEPTH OF DIVE AND INDICATION FOR HYPERBARIC OXYGEN TREATMENT

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Title: [abstract] COMPARISON OF SIGNIFICANT OTIC BAROTRAUMA BASED ON DEPTH OF DIVE AND INDICATION FOR HYPERBARIC OXYGEN TREATMENT
Author: Fiesseler, FW; Silverman, ME
Abstract: BACKGROUND: Hyperbaric oxygen therapy (HBOT) has been utilized for many years for a multitude of disease processes. One of the most frequently encountered side-effects of HBOT is otic barotrauma. We attempted to determine if patients with specific disease processes or those treated at a deeper depth were at increased risk of otic barotrauma during therapy. MATERIALS AND METHODS: Historical/clinical data was obtained retrospectively from Jan. 2000 to Dec. 2004, via a computerized tracking system. The hyperbaric facility is a suburban based hospital which performs treatments both emergent and non-emergently. Subset analysis by HBOT indication was performde. Requirement for a myringtomy tube(s) was considered significant otic barotrauma. Excluded were 15 patients who received tubes prior to HBOT. Statistical tests-- 95percent CI's calculated and Fisher exact test. RESULTS: 340 patients were screened, 325 met inclusion criteria. 63percent were male with median age being 56. Fifteen percent (50) of patients (95percent CI= 11-19percent) required tubes. Tubes were not required for the following treatment indications: air embolism (0/1), CO poison (0/23), gas gangrene (0/3), decompression sickness (0/3) or arterial insufficiency (0/2). Tubes were required: 5percent necrotizing soft tissue infection (1/20) (p=0.33), 10percent failed/threatened graft (5/52) (p=0.39), 15percent problem wounds (9/60) (p=1), 17percent chronic refractory osteomyelitis (7/40) (p=0.64), 22percent soft tissue radionecrosis/osteoradionecrosis (24/109) (p=0.02) and (4/12) 33percent of crush injuries (p=0.10). Subset analysis based on prior head/neck radiation (69 patients) demonstrated, 29percent required tubes (20/69) (p=0.001), of which 6 (30percent) were diagnosed with osteoradionecrosis. Sixteen percent (25/158) treated at 2.0 ATA, compared to 15percent (25/164) in the greater than 2.0 ATA group, required tubes. CONCLUSIONS: A moderate number of patients overall had otic barotrauma. Patients with prior head and neck radiation had a significant increase in otic barotrauma requiring tubes. No correlation regarding depth of treatment was demonstrated.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1623
Date: 2005

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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