Barotitis (ear squeeze) 氣壓性耳炎

(Tintinalli's Emergency Medicine)
Barotitis (ear squeeze) 氣壓性耳炎

症狀: 疼痛, 耳脹

耳鏡檢查可能正常, 耳膜出血, 中耳出血合併耳膜積血, 耳膜破裂

在下潛過程, 耳膜受擠壓可能破裂, 此時耳痛會突然減輕, 之後伴隨眩暈, 眩暈的原因是冷水從耳膜破洞流入中耳, 刺激單側前庭神經, 引起兩側前庭神經電訊號不平衡, 造成眩暈 VERTIGO. 突發性眩暈可能導致潛水員恐慌, 溺水, 或其他傷害. 

眩暈會有旋轉的感覺, 噁心, 嘔吐的症狀. 

治療: 保守治療為主. 

止痛藥. 抗組織胺 DECONGESTANT. 耳膜破裂考慮給抗生素, 耳膜尚未癒合之前不要潛水. 耳膜破裂多數會痊癒. 

耳膜破洞太大或一直未癒合轉介給ENT

潛水員如果得到氣壓性耳炎未合併耳膜破裂, 在能夠平衡患處中耳壓力之後才可以再度潛水. 

Barotitis can range from symptoms of pain or fullness  without otoscopic changes, to hemorrhage within the tympanic membrane or hemorrhage into the middle ear with hemotympanum. Ultimately, the tympanic membrane may rupture, resulting in relief of the pain but also possibly causing an influx of water into the middle ear. This, in turn, might cause calorically induced vertigo and potential panic, drowning, or other injury. 

Barotitis is treated conservatively with analgesics and decongestants. If tympanic membrane rupture occurs, antibiotics can be prescribed, especially if the diving occurred in contaminated water. Divers with perforated tympanic membranes should refrain from diving until the perforation heals. Most such perforations heal without difficulty, but referral to an otolaryngologist is appropriate for individuals with larger perforations or when healing does not occur. Divers with barotitis without perforation should refrain from diving until the diver is again able to equalize the pressure in the affected middle ear.