The International Tinnitus Journal

Middle ear barotrauma after hyperbaric oxygen therapy - the role of insuflation maneuvers

Objective: To analyze the association of insuflation maneuvers status before hyperbaric oxygen therapy with middle ear barotrauma.

Materials and Methods: Fouty-one patients (82 ears) admitted to the Department of Hyperbaric Medicine from May 2011 to July 2012. Assessments occurred: before and after the first session, after sessions with symptoms. During the evaluations were performed: otoscopy with Valsalva and Toynbee maneuvers, video otoscopy and specific questionnaire. Middle ear barotrauma was graduated by the modified Edmond’s scale. Tubal insuflation was classified in Good, Median and Bad according to combined results of Valsalva and Toynbee maneuvers. Inclusion criteria: patients evaluated by an otolaryngologist before and after the first session, with no history of ear disease, who agreed to participate in the research (convenience sample).

Results: Of the 82 ears included in the study, 32 (39%) had barotrauma after the first session. The rate of middle ear barotrauma according to tubal insuflation was: 17.9% (Good insuflation) 44.4% (Median insuflation) and 55.6% (Bad insuflation) (P = 0.013).

Conclusion: Positive Valsalva and Toynbee maneuvers before the first session, alone or associated were protective factors for middle ear barotrauma by ear after the first session.