This will in turn press the stapes into the oval window causing increased pressure in the cochlea and bulging of the round window. As a diver descends, the tympanic membrane (TM) will be pressed medially as the external pressure increases. There are two main ways the inner ear can experience barotrauma, through explosive or implosive means. This places the round window, as well as the oval window at risk of barotrauma with sudden changes in pressure. At the base of the cochlea, inferior to the oval window in the vestibule of the membranous labyrinth sits the round window, which compensates for the pressure changes in the fluid by flexing in and out in time with the fluid waves to prevent damage to the sensitive membranes. This is a fragile system, with any break of the basilar membrane causing disruption of the Organ of Corti and consequential hearing loss and disruption of Reissner’s membrane causing mixing of endolymph and perilymph with similar outcomes. These waves travel through the perilymph, pass to the endolymph and into the Organ of Corti where they are transformed into nerve impulses sent to the brain along the vestibulocochlear nerve. The pressure of the stapes bone in the middle ear moving in and out as it vibrates causes pressure waves within the perilymph fluid. Although very similar, these fluids are unique in their ionic compositions, which is important since the Organ of Corti, which is where sound waves are converted to electrochemical impulses, is located in the scala media on the basilar membrane and is bathed in endolymph. The scala vestibuli and tympani are filled with a fluid called perilymph and scala media with a similar fluid called endolymph. These scala are separated by membranes, Reissner’s membrane between the scala vestibuli and media and the basilar membrane between scala media and tympani. The cochlea is composed of three main divisions called scala within the bony labyrinth, the scala vestibuli most superior, scala media in the middle, and the scala tympani most inferior. The inner ear is a complex system encased within the bony labyrinth consisting of two major functional parts the vestibular apparatus concerned with balance and the cochlea dedicated to hearing, converting sound waves into electrical impulses passed to the brain. This article focuses on the intersection of these two processes in inner ear barotrauma (IEBt) and inner ear decompression sickness (inner ear DCS).
Amongst these risks, there are the ever-present spectra of decompression illness and barotrauma. We recommend you take good care of your ears and be aware of the risks to your hearing health in summer.For underwater divers, whether novice or experienced, there are many risks assumed whenever a new dive is planned. On the other hand, tympanostomy or pressure equalization (PE) tubes can be inserted in the eardrum to drain the ear if none of the solutions above are successful in improving the symptoms. On the one hand, certain medicines, such as nasal decongestants, antihistamines and steroid treatments may be helpful and can be taken in combination with antibiotics if there is a risk of infection due to a blockage in the eustachian tubes. Two treatments can be used to relieve ear barotrauma if none of the techniques above improve the situation.
This helps to push air into the eustachian tubes and counterbalance the negative air pressure in the middle ear. Recommended techniques for preventing ear barotrauma include chewing gum, yawning or carrying out the Valsalva manoeuvre, which involves closing the glottis, pinching the nose shut and exhaling forcefully.
0 kommentar(er)
