Inner ear barotrauma 內耳氣壓傷
( Tintinalli's Emergency Medicine ) Inner ear barotrauma 內耳氣壓傷. 通常下潛過程用力閉氣造成耳壓突然過大引起 症狀: 單側耳鳴. 聽力喪失, 嚴重暈眩 治療: 有爭議, 會診耳鼻喉科決定. 手術探查: 立即手術或延遲手術(保守治療無效,嚴重聽力受損,眼震圖明顯異常) 保守治療: 臥床頭部高,藥物治療眩暈,其他預防腦壓突然上升的治療,包括軟便劑, 避免捏鼻子吹氣 如因其他疾病要做高壓氧治療, 需先做緊急耳膜切開術. 內耳對氣壓傷害也很敏感, 有時候造成長期損傷, 潛水員如果嘗試閉氣用力以平衡中耳壓力, 當耳咽管阻塞時, 壓力差會藉由腦脊髓液CSF沿著前庭, 耳蝸, 中耳空間傳導至內耳, 導致卵圓窗 oval window or 圓窗 round window 破裂. 形成瘻管, 前庭膜撕裂. 如果耳咽管在下潛過程打開, 過度用力閉氣也會導致中耳壓力快速上升. 壓力傳導至內耳也會造成相似損傷. The inner ear is also susceptible to barotrauma, occasionally causing significant, long-term damage. If a diver attempts a forceful Valsalva maneuver to equalize the middle ear against an occluded Eustachian tube, the pressure differential between the cerebrospinal fluid, transmitted through the vestibular and cochlear structures and the middle ear air space, can cause rupture of the oval or round window, fistulization of the window, tearing of the vestibular membrane, or a com...