Two cases of rupture of the round window membrane resulted from inner ear barotrauma. Both patients were experienced divers who had difficulty in autoinflation while diving. One suffered from increasing deafness over several days with mild vertigo; both ears were affected. The other had pronounced vertigo without any cochlear symptoms or signs.
The ruptures were repaired with fat taken from the lobe of the ears, and both cases had satisfactory results, the first with improvement in hearing and the second with preservation of hearing. Both patients had been aware of difficulty with autoinflation for some time; nasal problems were responsible for this. All divers should have normal nasal function, and they should be educated in the technique of autoinflation and, in particular, in the importance of avoiding forceful autoinflation at all times.
Freeman P, Tonkin J, Edmonds C. Rupture of the Round Window Membrane in Inner Ear Barotrauma. Arch Otolaryngol. 1974;99(6):437–442. doi:10.1001/archotol.1974.00780030451010
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