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Saturday, April 9, 2011

MIDDLE EAR 'SQUEEZE'

Middle ear 'squeeze' is the commonest injury of divers. Sinus squeeze is less common.

Clinical features
Unless air is allowed into the middle ear to equalise pressure, the lining becomes oedematous, then haemorrhagic and the tympanic membrane may rupture at depths of 1-2m below. Rarely the round or oval window may rupture, causing severe vertigo, tinnitus and deafness. Both forms of squeeze, and reverse squeezes during decompression, also occur during air travel, especially in babies and in this with upper respiratory tract disease.
Management
Middle ear squeeze is prevented by Valsalva manoeuvre, or by ascending in response to pain, and is treated with decongestants such as 1% ephedrine nasal drops.

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