Persistent Inner Ear Injury after Diving

Rozsasi, Ajnacska; Sigg, Otto; Keck, Tilman

doi:10.1097/00129492-200303000-00011

Cited by 9 publications

(5 citation statements)

References 19 publications

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“…However, the ear is still the most commonly affected craniofacial region. Focus on the ear in our study suggests that this area might be particularly vulnerable in water-related activities, corroborating with multiple other studies 16,17 …”

Section: Discussionsupporting

confidence: 92%

“…Focus on the ear in our study suggests that this area might be particularly vulnerable in water-related activities, corroborating with multiple other studies. 16,17 It is worth noting that environmental factors, such as seasonality, also play a significant role in the incidence of trauma related to water activities. Most of the injuries in our population occurred from June to September which is the summer months.…”

Section: Discussionmentioning

confidence: 99%

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Craniofacial Injuries in Swimming and Water Sports: Implications for Prevention

Mangal,

Desai,

Treger

et al. 2024

Journal of Craniofacial Surgery

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Introduction: Water-related recreational activities, including swimming and diving, are widespread. However, they carry a significant risk of craniofacial injuries. Despite the popularity of these activities, comprehensive data on injuries beyond drowning remain scant. This study addresses this gap by providing valuable epidemiological insight into the nature, prevalence, and demographic patterns of craniofacial injuries related to water sports activities. Methods: The authors queried the NEISS database for craniofacial injuries related to swimming, diving, and water sports from 2013 to 2022. Data were analyzed for demographics, anatomic locations of injuries, and the activities leading to these injuries. Results: Between 2013 and 2022, a total of 952,111 craniofacial injuries were associated with swimming and water sports. Of these, 510,706 (53.6%) were male patients, and 441,405 (46.4%) were female. This indicates that males were 1.16 times more likely to sustain such injuries. The age groups most affected were 0 to 9 and 10 to 19 years. Anatomic locations impacted were as follows: ears (58.1%), head (16.8%), face (13.9%), neck (4.8%), eyeballs (4.4%), and mouth (2%). Leading causes were identified as swimming and water sports activities (66.5%), swimming pools and equipment (28.2%), diving or diving boards (4.7%), and scuba diving (0.5%). Notably, 89.2% of patients with diving-related injuries and 99.1% with swimming-related injuries were not admitted to the hospital. Conclusions: This study offers critical epidemiological data to supplement targeted prevention strategies and resource allocation in managing craniofacial injuries associated with water activities. The findings highlight the urgent need for specialized care and serve as a foundation for future preventive initiatives.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Craniofacial Injuries in Swimming and Water Sports: Implications for Prevention

Mangal,

Desai,

Treger

et al. 2024

Journal of Craniofacial Surgery

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“…These observations signify the physiological importance of the RW membrane for audition, and the necessity to retain it, which has been revealed during surgery of the middle and inner ear [5]. Traumatic damage or rupture of the RW membrane can cause hearing loss and deafness owing to perilymph aspiration or loss of the normal pressure-releasing function of a compliant RW [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

A novel mechanism of cochlear excitation during simultaneous stimulation and pressure relief through the round window

Weddell

Yarin

Drexl³

et al. 2014

J. R. Soc. Interface.

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The round window (RW) membrane provides pressure relief when the cochlea is excited by sound. Here, we report measurements of cochlear function from guinea pigs when the cochlea was stimulated at acoustic frequencies by movements of a miniature magnet which partially occluded the RW. Maximum cochlear sensitivity, corresponding to subnanometre magnet displacements at neural thresholds, was observed for frequencies around 20 kHz, which is similar to that for acoustic stimulation. Neural response latencies to acoustic and RW stimulation were similar and taken to indicate that both means of stimulation resulted in the generation of conventional travelling waves along the cochlear partition. It was concluded that the relatively high impedance of the ossicles, as seen from the cochlea, enabled the region of the RW not occluded by the magnet, to act as a pressure shunt during RW stimulation. We propose that travelling waves, similar to those owing to acoustic farfield pressure changes, are driven by a jet-like, near-field component of a complex pressure field, which is generated by the magnetically vibrated RW. Outcomes of research described here are theoretical and practical design principles for the development of new types of hearing aids, which use near-field, RW excitation of the cochlea.

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“…Many of these patients were supposed to have a predisposing incident with consecutive pressure elevation in the inner ear. Otic barotrauma is well-documented in air travel [4] and diving accidents [5], but there are also patients suffering from sudden deafness related to the rupture of theRWM without any barotrauma.…”

Section: Introductionmentioning

confidence: 99%

Occurence of a round window membrane rupture in patients with sudden sensorineural hearing loss

Haubner

Rohrmeier

Koch

et al. 2012

BMC Ear Nose Throat Disord

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Background: Aim of the present study was to evaluate the occurence of a round window membrane rupture and the effects of hearing restoration after exploratory tympanotomy and sealing of the round window (niche) in patients with unilateral sudden deafness. Methods: Retrospective analysis of patients' charts in a tertiary referral center. Charts of 69 patients with sudden deafness followed by exploratory tympanotomy were retrospectively analyzed. Pure-tone audiometry data before and after tympanotomy were compared to determine the outcome of hearing recovery. The postoperative hearing test values were documented 3 weeks after tympanotomy. All surgical reports were reviewed with regard to the surgical technique performed and the intraoperative findings. Results: 18.8% of the patients revealed a visible perilymphatic fistula in the round window niche. 89.8% of the patients reported no typical history for a round window membrane rupture. All patients were treated with an exploratory tympanotomy under local anesthesia and an intravenous corticosteroid treatment regimen. The majority of the surgeons used a fat plomb to cover the round window. Postoperative hearing was significantly improved compared to the preoperative hearing test data. No patient showed a worsened hearing curve after the treatment. Conclusion: Most patients suffering from unilateral sudden deafness had no visible perilymphatic fistula. In our study population, the majority of patients reported no typical history of a pressure elevation in the inner ear. Exploratory tympanotomy is a safe procedure that may support hearing recovery in patients with sudden deafness in addition to the established treatment regimen including high-dose steroids.

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Persistent Inner Ear Injury after Diving

Abstract: Rupture of the round window may occur after diving even if the dive is performed from a low height into the water and the bottom of the pool is not contacted. Besides direct contusion to the external ear and barotrauma, other causes such as whiplash mechanism have to be considered.

Cited by 9 publications

References 19 publications

Craniofacial Injuries in Swimming and Water Sports: Implications for Prevention

Craniofacial Injuries in Swimming and Water Sports: Implications for Prevention

A novel mechanism of cochlear excitation during simultaneous stimulation and pressure relief through the round window

Occurence of a round window membrane rupture in patients with sudden sensorineural hearing loss

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