Otitic Barotrauma occurs while ?
Correct Answer: Underwater diving
Description: Ans. is `c' i.e., Underwater diving Otitic Barotrauma This condition is seen when the ambient pressure is rising, e.g. in scuba diving (underwater diving), descending in an aircraft, or compression in pressure chamber. It occurs due to pressure differences between the inside and outside of the eardrum. Clinical features Ear discomfo or pain, hearing loss, and tinnitus are common Veigo is uncommon Otoscopy findings are :- Congested and retracted tympanic membrane Blood may extravasate into middle ear producing haemotympanum On examination there is conductive deafness. Pathogenesis of otitic barotrauma The middle ear pressure is normally maintained at a level similar to that of the atmosphere by the function of Eustachian tube which allows passage of air from middle ear to pharynx. Sudden or dramatic changes of external pressure may defeat this mechanism and cause injury to middle ear. When atmospheric pressure is higher than that of middle ear by critical level of 90 mm Hg, eustachian tube gets locked as the soft tissues of pharyngeal end of the tube are forced into the lumen by high atmospheric pressure. This results in sudden negative pressure in the middle ear which causes retraction of tympanic membrane, hyperemia, transudation with hemorrhage and development of Aero-otitis media (barotrauma). At pressure difference >100 to 500 mm Hg, tympanic membrane can rupture when the pressure difference is more than 100 mg Hg, tympanic membrane can rupture. Treatment of otitic Barotrauma Routine self treatment of pain associated with changing pressure in air craft includes chewing gum, attempting to yawn & swallow, blowing against closed nostrils, and using decongestant nasal sprays. The aim is to restore middle ear areation. Catheterization or politzerization can also be used. If the eustachian tube will not open with other treatments, surgery may be necessory. Myringotomy and aspiration of fluid is the surgical procedure used.
Category:
ENT
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