middle ear barotrauma
Introduction
Introduction to middle ear pressure injury In the flight due to changes in altitude or changes in depth during diving, atmospheric pressure also changes, the eustachian tube function is poor, can not adjust the pressure inside the drum chamber in time, resulting in imbalance of pressure inside and outside the drum caused by middle ear injury called middle ear pressure injury . Negative pressure in the tympanic cavity can cause blood vessels in the submucosal tissue to dilate and cause serum to leak out, even bleeding, forming middle ear effusion or hemorrhage. The main symptom of the disease is that the negative pressure in the tympanic cavity can cause the blood vessels of the submucosal tissue to dilate, causing the serum to leak out, or even hemorrhage, forming a middle ear effusion or hemorrhage. The tympanic membrane itself may increase with the negative pressure of the middle ear, and the invagination may occur. , congestion, mucous membrane layer and fibrous layer peeling, and even perforation, therefore, the performance of sudden feelings of ear suffocation, tinnitus, headache, dizziness and other symptoms, the light only feels ear suffocation, after a few hours, healed, severe earache, tinnitus and Suction loss is obvious, and it can be recovered in the future. For example, due to tympanic effusion, blood accumulation is not easy to absorb, and it can last for several days. In some serious cases, the tympanic membrane can be congested, and even the tympanic membrane can be perforated. After repeated injuries, the tympanic membrane often It is trapped, turbid and thick, and the activity is poor. basic knowledge Sickness ratio: 0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: tympanic perforation
Cause
Middle ear barotrauma
Pressure difference (50%)
The normal human eustachian tube is opened several times per minute and can be opened every 5 seconds during sleep. If the flight drops by 15m per second, no damage will occur. In particular, the air pressure in the closed cabin is slowly mutated, so that the middle ear pressure is not damaged. However, when the distance from the ground is lower, the descending speed is too fast, and a large air pressure difference occurs in a short time. If there is no active ventilation, the middle ear pressure is likely to occur. When diving, the tympanic membrane may be ruptured due to the failure to blow the eustachian tube by itself to restore the balance between the middle ear pressure and the external pressure.
Disease factor (30%)
Nasal and nasopharyngeal diseases, such as acute and chronic rhinitis, acute and chronic tonsillitis, adenoid hypertrophy, nasal allergic diseases, nasopharyngeal tumors, pharyngeal muscle spasm, mandibular joint disease and poor teeth, can affect the pharynx The sphygmomanometer function is an important factor in the development of barium-induced middle ear injury.
Prevention
Middle ear pressure injury prevention
The middle ear pressure injury should be prevented, and each occupant should be taught how to do swallowing and pinching the nose. The flight crew should mainly perform open training on the eustachian tube muscle, including swallowing, lifting throat, soft palate movement and jaw movement. Before taking the flight, it is advisable to use 1 ephedrine solution in the nose to make the nasal cavity unobstructed, the eustachian tube not to be occluded, and if necessary, temporarily stop flying. If the driver has earache, he can fly back to the original height, then descend at low speed and continue to make The eustachian tube is open to avoid damage to the middle ear. Avoid spicy foods and greasy foods, avoid smoking and drinking, so as not to cause resistance and regulation. Avoid cold, tired, and diet should be light.
Complication
Middle ear barotrauma complications Complications
In severe cases, tympanic membrane rupture can also occur.
Symptom
Middle ear barotrauma symptoms Common symptoms Earache, tinnitus, ear suffocation, tympanic membrane, congested ear, tympanic membrane, ruptured auricle, bruise, air pressure, injury, dizziness, ear, ear canal, laceration, ear pain
Negative pressure in the tympanic cavity can cause vasodilatation of the submucosal tissue, causing leakage of serum, even bleeding, formation of middle ear effusion or blood accumulation, and the tympanic membrane itself may become invaginated, congested, mucosal and with the aggravation of the negative pressure in the middle ear. The fibrous layer is peeled off and even perforated. Therefore, the symptoms of sudden feelings of ear tingling, tinnitus, headache, dizziness, etc., are only mild to ear suffocation, and are healed after a few hours. In severe cases, earache, tinnitus and suction loss are obvious, and in the future, Recoverable, such as due to tympanic effusion, blood is not easy to absorb, can last for several days, some serious cases can be full of tympanic membrane can be congested, even the tympanic membrane perforation, repeated repeated damage, the tympanic membrane often invagination, turbid thickening, The activity is poor and it is vocal.
Examine
Middle ear pressure injury check
The tympanic membrane is congested, the cone of light disappears, the liquid level is visible, the tympanic membrane can be examined by electric otoscope, the hearing change is detected by pure tone audiometry, and the pressure curve of the tympanic chamber is shown as "C" shape.
Diagnosis
Diagnosis and diagnosis of middle ear pressure injury
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Need to be differentiated from other ear lesions such as otitis media, otitis media with numbness or blockage in the ear, hearing loss and tinnitus are the most common symptoms, often occur after a cold, or unconsciously occur, sometimes head position changes Hearing improvement, self-improvement, some patients have mild earache, children often appear to be obedient or inattentive.
