Inner ear decompression sickness after a routine dive and recompression chamber drill
LCDR Dale Parsons, MD1; CDR (Ret) Edward Utz, MD2; CAPT Grant Kidd, DO3; CAPT Gina Virgilio, MD4
1 School of Infantry – West, Camp Pendleton, California, U.S.
2 Head & Neck Surgery Department, Kaiser Permanente San Diego Medical Center, San Diego, California, U.S. 3 Navy Experimental Diving Unit, Panama City Beach, Florida, U.S.
4 Explosive Ordnance Disposal Group ONE, San Diego, California, U.S.
CORRESPONDING AUTHOR: Dale Parsons – dale.a.parsons7.mil@health.mil
ABSTRACT
Parsons D, Utz E, Kidd G, Virgilio G. Inner ear decompression sickness after a routine dive and recompression chamber drill. Undersea Hyperb Med. 2024 Second Quarter; 51(2):129-135.
Inner ear decompression sickness (IEDCS) is an uncommon diving-related injury affecting the vestibulocochlear system, with symptoms typically including vertigo, tinnitus, and hearing loss, either
in isolation or combination. Classically associated with deep, mixed-gas diving, more recent case series have shown that IEDCS is indeed possible after seemingly innocuous recreational dives, and there has been one previous report of IEDCS following routine hyperbaric chamber operations. The presence of right-to-left shunt (RLS), dehydration, and increases in intrathoracic pressure have been identified as risk factors for IEDCS, and previous studies have shown a predominance of vestibular rather than cochlear symptoms, with a preference for lateralization to the right side. Most importantly, rapid identification and initiation of recompression treatment are critical to preventing long-term or permanent inner ear deficits. This case of a U.S. Navy (USN) diver with previously unidentified RLS reemphasizes the potential for IEDCS following uncomplicated diving and recompression chamber operations – only the second reported instance of the latter.
Keywords: hyperbaric oxygen; inner ear barotrauma; inside tender; patent foramen ovale (PFO); right-to- left shunt (RLS)
DOI:10.22462/599