barotraumatic otitis media
Introduction
Introduction to barotratrastal otitis media When the atmospheric pressure suddenly changes, the eustachian tube mouth cannot open smoothly to adjust the pressure in the tympanic chamber, thus causing damage to the tympanic cavity, similar to aseptic otitis media, which is called air pressure injury. Under normal circumstances, the eustachian tube is opened momentarily when swallowing, yawning and blowing nose, so that the pressure inside the drum room and the outside air pressure are balanced. When the eustachian tube has pathological changes, such as cold, sinusitis, nasopharyngeal tumor, nasal polyps, nasal septum deviation, pharyngeal muscle paralysis and occlusion of the maxillary joint, or in the sleep and coma, the eustachian tube loses normal regulation. The function of air pressure, which is an internal factor, the sudden changes in the external pressure, such as naval diving, air force lift and hyperbaric oxygen chamber treatment, etc., if there is no good protective measures, it is easy to cause pressure tympanic damage, which is an external factor. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: tinnitus, deafness, dizziness, nausea and vomiting
Cause
Cause of barotrauma otitis media
The higher the normal air force takes off, the lower the atmospheric pressure, and the higher the pressure in the drum chamber. When the pressure difference between the inside and outside of the drum reaches 2 kPa (equivalent to 152 meters), the gas in the drum chamber will escape from the eustachian tube, thereby maintaining The pressure balance inside and outside the drum, if the volley continues to fly high, whenever the pressure difference reaches 1.5kPa, the eustachian tube can be automatically opened once for adjustment, so the lift is high, and the tympanic trauma is not easy to occur. On the contrary, the air pressure drops from the upper air. When the pressure is increased and the pressure inside the air is gradually reduced, it is difficult for the outside air to open the eustachian tube and enter the tympanic chamber.
Low-altitude subduction flight is much worse than high-altitude subduction pressure, so the incidence of tympanic trauma is also relatively high. It often occurs at an altitude of 1000-4000 meters. The diver launches water and increases the atmospheric pressure every 10 meters. If you do not inhale compressed air, it will also Causes tympanic trauma. Once the tympanic cavity forms a negative pressure, the tympanic membrane will invade, the mucosal blood vessels will also expand and edema, and even bleeding may occur.
Prevention
Pneumatic traumatic otitis media prevention
Before conducting flight or diving, detailed physical examination should be carried out. Patients with chronic inflammation or obstructive lesions or middle ear infections in the nasal cavity, nasopharynx, etc. should be actively treated. Those with acute rhinitis, sinusitis or upper respiratory tract infection should be suspended or Diving, when the plane is falling, it is not allowed to fall asleep, and it is constantly swallowing, such as chewing gum, yawning, drinking a drink or pinching the nose to keep the eustachian tube open, and the professional pilot or diver should perform an eustachian. Open exercise training, such as swallowing, lifting throat, soft palate movement and jaw movement.
Complication
Pulmonary traumatic otitis media complications Complications, tinnitus, deafness, vertigo, nausea and vomiting
The tympanic membrane is ruptured, the ear pain, the tinnitus, the deafness is aggravated, and there are dizziness, nausea, vomiting, etc., generally lasting for half a day to two days, the symptoms gradually disappear, the tympanic membrane is congested, the blood around the hammer stem is congested, and there is scattered bleeding. Sometimes the blood plane and air bubbles are visible through the tympanic membrane, and the tympanic membrane is linearly perforated.
Symptom
Pneumatic traumatic middle ear inflammation symptoms Common symptoms Acute pain, tinnitus, ear tympanic membrane rupture, traumatic bleeding, earache, barotrauma, vomiting, congestion, trauma, ear occlusion
The flight gradually rises, or the diver gradually rises to the surface of the water. The drumsticks are all pressed into the low pressure by the high pressure. The eustachian tube can be opened and adjusted at regular intervals, so the symptoms are less likely to occur, occasionally nausea and tinnitus, and vice versa, such as sudden subduction or rapid decline. Shen, the eustachian tube will lose its regulating function, especially in the pathological state, it is easy to cause tympanic trauma. First, severe tinnitus, deafness, wateryness in the ear, earache can be radiated to the cheeks and cheeks, and the final pressure reaches 14kPa. Above, the tympanic membrane rupture, severe pain in the ear, tinnitus, aggravation of deafness, and dizziness, nausea, vomiting, etc., generally lasts for half a day to two days, the symptoms gradually disappear, the tympanic membrane is congested, the blood around the hammer stem is congested, there is scattered At the bleeding point, sometimes the blood plane and air bubbles are visible through the tympanic membrane, and the tympanic membrane is linearly perforated.
Examine
Examination of barotrauma otitis media
Check: light tympanic membrane invagination, relaxation and hammer stem and other places are congested; severe tympanic effusion, through the tympanic membrane visible liquid level or bubbles; some tympanic blood, tympanic membrane can be dark blue or purple, sometimes the tympanic membrane surface There are blood blisters, ecchymoses, or fissure-like perforation of the tympanic membrane, often a conductive deafness.
Diagnosis
Diagnosis and differentiation of barotrauma otitis media
It should be differentiated from traumatic otitis media caused by other causes.
