The investigators plan to perform a randomized double blind placebo control trial to determine if pseudoephedrine is effective in decreasing the rate of MEB during HBOT. The condition known as ear barotrauma occurs when there is excess stress on your ear drum caused by change in pressure which your ear is finding it difficult to. However, the use of pseudoephedrine for patients undergoing HBOT has not been studied. Other studies involving scuba divers and airplane travelers showed that oral pseudoephedrine is effective in decreasing MEB. This is despite two negative studies showing that this medication does not work any better than placebo. At our facility, oxymetazoline, a topical nasal decongestant, is the standard rescue medication administered for patients that have symptoms of MEB during HBOT. In rare cases, a ventilation tube in the eardrum may be needed to equalize pressure between the middle ear and outside air. A surgeon may rebuild the eardrum or the opening into the inner ear. Currently there is no objective criteria for predicting which patients will experience these complications, nor is there consensus on effective prevention measures. You may need surgery if your ear barotrauma is severe.
Last year 27/991 treatments at our Center for Hyperbaric and Dive Medicine were aborted due to MEB. Causes The air pressure in the middle ear is most often the same as the air pressure outside of the body. The severe discomfort associated with MEB sometimes causes HBOT to be postponed or abandoned. Medical Encyclopedia Ear barotrauma Ear barotrauma Ear barotrauma causes discomfort in the ear due to pressure differences between the inside and outside of the eardrum. The incidence of MEB, depending on the definition used is between 2-45%. The spectrum of symptoms ranges from sensation of ear fullness and muffled hearing to severe pain, vertigo and tympanic membrane rupture. Hemotympanum refers to both the presence of blood in the middle ear cavity and to ecchymosis of the tympanic membrane (TM). Patients experiencing MEB usually feel pressure or pain in their ear(s). The most commonly associated complication of HBOT is middle ear barotrauma (MEB) which occurs when the eustachian tube does not allow air to enter the middle ear space to equalize the pressure between the ambient environment and the inner ear. Hyperbaric oxygen therapy (HBOT) utilizes 100% oxygen delivery at a pressure greater than 1 atm for the treatment of various emergent medical conditions including carbon monoxide poisoning. Why Should I Register and Submit Results?.
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