To the Editor.—Freeman and Edmonds reported five cases of "Inner Ear Barotrauma." In each case persistent sensorineural hearing loss followed diving episodes. All five patients were trained Navy divers with preincident and postincident audiograms. The authors point out clearly that in none of the cases could the inner ear lesion be attributed to decompression sickness or to pulmonary barotrauma. Thus, nitrogen embolization has been ruled out by the authors as a possible etiologic factor.
All five divers had difficulty in performing Valsalva maneuvers on the affected side, but in only one case was there otoscopic evidence of middle ear involvement. In several cases vestibular symptoms were also present. The hearing losses were either immediate or delayed by a number of hours. Barotrauma seems a likely etiologic factor and "inner ear barotrauma" is a reasonable descriptive term.
In the discussion of mechanisms, the authors discuss the possible effect of pressure
VICTOR GOODHILL. INNER EAR BAROTRAUMA. Arch Otolaryngol. 1972;95(6):588. doi:10.1001/archotol.1972.00770080878017