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March 2018

Otorhinolaryngology and Diving—Part 2: Otorhinolaryngological Fitness for Compressed Gas Scuba Diving: A Review

Author Affiliations
  • 1Royal National Throat, Nose and Ear Hospital, University College London Hospitals NHS Trust, London, England
  • 2Duke Skull Base Center, Duke University School of Medicine, Durham, North Carolina
  • 3Departments of Anesthesiology and Medicine, and Center for Hyperbaric Medicine and Environmental Physiology, Duke University School of Medicine, Durham, North Carolina
  • 4Department of Otolaryngology, Addenbrooke's Hospital, Cambridge, England
  • 5currently in private practice, Munich, Germany
  • 6City, University of London, London, England
JAMA Otolaryngol Head Neck Surg. 2018;144(3):259-263. doi:10.1001/jamaoto.2017.2616

Importance  Self-contained underwater breathing apparatus (scuba) diving has become increasingly popular with millions of people diving each year. Otorhinolaryngologists are often consulted either by patients or diving physicians regarding fitness to dive, and at present, the guidelines do not provide comprehensive information regarding the evaluation of this patient cohort. The aim of this review is to provide a comprehensive overview of existing otorhinolaryngological guidelines for fitness to dive recreationally.

Observations  There is a paucity of guidelines for assessing otorhinolaryngological fitness to dive in the recreational diver. Comprehensive guidelines exist from US, European, and UK regulatory bodies regarding fitness for commercial diving; however, not all of these can be directly extrapolated to the recreational diver. There are also a variety of conditions that are not covered either by the existing fitness for recreational diving guidelines or the commercial regulatory bodies.

Conclusions and Relevance  With the paucity of recreational fitness to dive guidelines we must draw on information from the commercial diving regulatory bodies. We have provided our own recommendations on the conditions that are not covered by either of the above, to provide otorhinolaryngologists with the information they require to assess fitness for recreational diving.

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