Otorhinolaryngology and Diving-Part 1: Otorhinolaryngological Hazards Related to Compressed Gas Scuba Diving: A Review.


Scuba diving is becoming increasingly popular. However, scuba diving is associated with specific risks; 80% of adults and 85% of juvenile divers (aged 6-17 years) have been reputed to have an ear, nose, or throat complaint related to diving at some point during their diving career. Divers frequently seek advice from primary care physicians, diving physicians, and otorhinolaryngologists, not only in the acute setting, but also related to the long-term effects of diving.The principles underpinning diving-related injuries that may present to the otorhinolaryngologist rely on gas volume and gas saturation laws, and the prevention of these injuries requires both that the diver is skilled and that their anatomy allows for pressure equalization between the various anatomical compartments. The overlapping symptoms of middle ear barotrauma, inner ear barotrauma, and inner ear decompression sickness can cause a diagnostic conundrum, and a thorough history of both the diver's symptoms and the dive itself are required to elucidate the diagnosis. Correct diagnosis and appropriate treatment result in a more timely return to safe diving.The aim of this review is to provide a comprehensive overview of otorhinolaryngological complications during diving. With the increasing popularity of diving and the frequency of ear, nose, or throat-related injuries, it could be expected that these injuries will become more common and this review provides a resource for otorhinolaryngologists to diagnose and treat these conditions.





Published Version (Please cite this version)


Publication Info

Lechner, Matt, Liam Sutton, Jonathan M Fishman, David M Kaylie, Richard E Moon, Liam Masterson, Christoph Klingmann, Martin A Birchall, et al. (2018). Otorhinolaryngology and Diving-Part 1: Otorhinolaryngological Hazards Related to Compressed Gas Scuba Diving: A Review. JAMA otolaryngology-- head & neck surgery, 144(3). pp. 252–258. 10.1001/jamaoto.2017.2617 Retrieved from https://hdl.handle.net/10161/18106.

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David Marcus Kaylie

Professor of Head and Neck Surgery & Communication Sciences

Dr. Kaylie is an Associate Professor in the Division of Head and Neck Surgery & Communication sciences.  He is the medical director for the Duke Vestibular Disorders Clinic, Medical Director for Duke Otolaryngology Clinic and Co-Medical Director for the Duke Skull Base Center.  Dr. Kaylie's research interests are in balance disorders after cochlear implant surgery as well as hearing preservation in skull base surgery.  He currently serves on several committees for the American Academy of Otolaryngology and has lectured and taught nationally and internationally on ear and skull base surgery. 


Richard Edward Moon

Professor of Anesthesiology

Research interests include the study of cardiorespiratory function in humans during challenging clinical settings including the perioperative period, and exposure to environmental conditions such as diving and high altitude. Studies have included gas exchange during diving, the pathophysiology of high altitude and immersion pulmonary edema, the effect of anesthesia and postoperative analgesia on pulmonary function and monitoring of tissue oxygenation. Ongoing human studies include the effect of respiratory muscle training on chemosensitivity and blood gases during stressful breathing: underwater exercise.

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