Table 2.
Studies looking at middle ear barotrauma (MEB) in divers
| Paper | Study design | Country | Assessment | Sample & size | Disorder, frequency | Study conclusions |
|---|---|---|---|---|---|---|
| Green et al. [22] | Pilot study | USA | Multiple diving day otoscopy, tympanometry, Teed’s classification | 2 experienced scuba divers | 23% otalgia 33% abnormal tymps 83% abnormal otoscopy by day 3 |
Long surface time intervals between multiple dives is important for MEB prevention |
| Uzun et al. [23] | Observational cohort study | Turkey | Toynbee/Vasalva/nine-step inflation technique within 24 h of diving | 22 sports divers | N/A | The NSIDT is a valuable diagnostic measure for MEB |
| Uzun et al. [24] | Prospective | Turkey | Simplified rectangular dimension method | 24 sports divers | MEB occurred in 11 divers (46%) | There is a relationship between the size of the mastoid pneumatisation |
| Blinded | ||||||
| Uzun [25] | Prospective blinded | Turkey | Examined 24 h after diving | 31 sports divers | MEB occurred in 14 (45%) | MEB tests should be performed as part of pre-dive examination |
| Ramos et al [26] | Observational study | Brazil | Four dives per day for 5 days audiology assessment + Teed’s classification | 19 recreational divers | MEB—71% otoscopic change noticed | Extending surface time may offer protection against MEB |