Impact of apnea diving on the middle ear: First prospective observational study

Introduction:

During apnea diving, the ear is exposed to strong pressure changes in an extremely short time. The aim of this study was to evaluate the frequency of barotrauma during typical apnea training and to characterize possible risk factors.

Methods:

17 adult apneists were examined during diving training in a 20 m deep pool (Dive4Life, Siegburg). Before the start of the dive and after each apnea session a 4 dives (TG; excl. safety TG at half depth) a bilateral endoscopic ear finding was made. The changes of the eardrum in the sense of barotrauma were classified according to TEED 0 – 4 (standard findings up to perforation). Subjective complaints during diving (yes/no) were assessed using a questionnaire.

Results:

A total of 148 TG were performed. The mean number of dives per subject was 19; per session each person performed a total of 6 dives (4 own+2 backup dives). The average TG depth was 13.3 m. Initially, the standard TEED 0 was 28/32 ears (88%). After completion of the dive 40% of the ears showed an ear finding TEED 1 and 8% TEED 2. With increasing number of apnoea sessions the number of findings with TEED≠ increased continuously (p < 0.0001). Subjects with barotrauma TEED 2 performed significantly flatter TGs than subjects with TEED 0 and 1 (p = 0.049 and p = 0.018, respectively). Subjects with a higher TEED level reported significantly more complaints (p = 0.003).

Conclusions:

Increasing stress during apnea diving, measured by the number of dives, led to a significantly higher incidence of barotrauma. The severity of barotrauma correlated with diving depth and with subjective complaints.

Publikationsverlauf

Publikationsdatum:
23. April 2019 (online)