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Altered Eustachian Tube Function in SCUBA Divers With Alternobaric Vertigo

Kitajima, Naoharu*†; Sugita-Kitajima, Akemi*‡; Kitajima, Seiji*

doi: 10.1097/MAO.0000000000000329
Vestibular Disorders

Objectives The number of people participating in sport self-contained underwater breathing apparatus (SCUBA) diving has increased tremendously, bringing with it a rise in diving accidents. Alternobaric vertigo (AV) is a common problem in SCUBA divers. We investigated the relationship between Eustachian tube function and incidence of AV in sport SCUBA divers. We also followed the progress of these divers after Eustachian tube function improved.

Method Forty-four patients who experienced a SCUBA diving accident affecting the middle ear (11 men and 33 women; mean ± SD: 37.5 ± 11.5 yr) and 20 healthy volunteer divers who did not experience an accident (6 men and 14 women; mean ± SD: 33.5 ± 13.9 yr) were compared. We divided the divers with an accident into two groups (those with AV vs. those without) and then compared the two groups. All patients regularly underwent Eustachian tube function tests (sonotubometry and impedance test).

Results In sonotubometry and impedance testing, the mean duration (p < 0.001), amplitude (p < 0.002), and maximum air content (p < 0.05) of divers who experienced a diving accident were significantly different from those of healthy volunteers. However, these parameters in divers with AV did not differ significantly from those in divers without AV. In 7 of 15 divers, vestibular symptoms disappeared immediately after ascent. In the remaining eight divers, however, vertigo/dizziness persisted and even was observed at their first clinic visit.

Conclusion To prevent AV or barotraumas in SCUBA divers, we recommend a thorough Eustachian tube function evaluation. Any dysfunction should be treated before engaging in SCUBA diving.

*Kitajima ENT Clinic, 1-15-15 Tagara Nerima-ku, Tokyo, Japan; †Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; and ‡Department of Otolaryngology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan

Address correspondence and reprint requests to Naoharu Kitajima, M.D., Ph.D., Kitajima ENT Clinic, 1-15-15 Tagara Nerima-ku, Tokyo 179-0073, Japan; E-mail:

The authors report no conflicts of interest.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company