Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-18T06:44:26.839Z Has data issue: false hasContentIssue false

Relation between temporal bone pneumatisation and middle-ear barotrauma in aircrew members

Published online by Cambridge University Press:  27 September 2019

A Hussein*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
H M Abdel Tawab
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
W T Lotfi
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Fayoum University, Egypt
N Fayad
Affiliation:
Department of Radiology, Faculty of Medicine, Al Azhar University, Egypt
N Elsisy
Affiliation:
Department of Otorhinolaryngology, Student Hospital, Cairo University, Giza, Egypt
*
Author for correspondence: Dr Ahmed Hussein, Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt E-mail: [email protected]

Abstract

Objective

This study aimed to assess the potential role of pneumatisation of the mastoid and its communicating air cells in the development of middle-ear barotrauma in aircrew members.

Methods

Seventy-nine aircrew members (158 ears) underwent temporal computed tomography. All were assessed before flying by clinical examination and audiology evaluation, followed by post-flight examination to detect barotrauma.

Results

Aircrew members’ ears were divided into 3 groups based on barotrauma and temporal bone pneumatisation: 33 ears with barotrauma and temporal bone pneumatisation of 71 cm3 or greater (group A); 12 ears with barotrauma and temporal bone pneumatisation of 11.2 cm3 or lower (group B); and 113 ears with no barotrauma (group C). Mean pneumatisation volumes were 91.05 cm3, 5.45 cm3 and 28.01 cm3 in groups A, B and C, respectively. A direct relationship was observed between volume of temporal bone pneumatisation of 71 cm3 or greater and barotrauma grade.

Conclusion

Pneumatisation volume of the mastoid and its communicating air cells that ranges from 11.3 cm3 to 70.4 cm3 serves as a reliable predictor of the avoidance of middle-ear barotrauma associated with flying in aircrew members who have normal resting middle-ear pressure and good Eustachian tube function.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr A Hussein takes responsibility for the integrity of the content of the paper

References

1Ghosh, MS, Kumar, WCNA. Study of middle ear pressure in relation to Eustachian tube patency. Ind J Aerospace Med 2002;46:2731Google Scholar
2Mirza, S, Richardson, H. Otic barotrauma from air travel. J Laryngol Otol 2005;119:366–70Google Scholar
3Lewis, ST. Barotrauma in United States Air Force accidents-incidents. Aerosp Med 1973;44:1059–61Google Scholar
4Hussein, A, Abousetta, A. Use of the nine-step inflation/deflation test and resting middle-ear pressure range as predictors of middle-ear barotrauma in aircrew members. J Laryngol Otol 2014;128:612–17Google Scholar
5Virapongse, C, Sarwar, M, Bhimani, S, Sasaki, C, Shapiro, R. Computed tomography of temporal bone pneumatization. II: Petrosquamosal suture and septum. Am J Neuroradiol 1985;6:561–8Google Scholar
6Bluestone, CD, Doyle, WJ. Anatomy and physiology of Eustachian tube and middle ear related to otitis media. J Allergy Clin Immunol 1988;81:9971003Google Scholar
7Isono, M, Murata, K, Azuma, H, Ishikawa, M, Ito, A. Computerized assessment of the mastoid air cell system. Auris Nasus Larynx 1999;26:139–45Google Scholar
8Lundgren, CE, Malm, LU. Alternobaric vertigo among pilots. Aerosp Med 1966;37:178–80Google Scholar
9Brown, TP. Middle ear symptoms while flying: ways to prevent a severe outcome. Postgrad Med 1994;96:135–42Google Scholar
10King, PF. Otic barotraumas. Audiology 1976;15:279–86Google Scholar
11Uzun, C, Adali, MK, Koten, M, Yagiz, R, Aydin, S, Cakir, B et al. Relationship between mastoid pneumatization and middle ear barotrauma in divers. Laryngoscope 2002;112:287–91Google Scholar
12Sade, J, Ar, A, Fuchs, C. Barotrauma vis-a-vis the “chronic otitis media syndrome”: two conditions with middle ear gas deficiency. Is secretory otitis media a contraindication to air travel? Ann Otol Rhinol Laryngol 2003;112:230–5Google Scholar
13Toklu, AS, Shupak, A, Yildiz, S, Aktas, S, Ertracht, O, Ay, H et al. Aural barotrauma in submarine escape: is mastoid pneumatization of significance? Laryngoscope 2005;115:1305–9Google Scholar
14Bluestone, CD, Cantekin, EL. Current clinical methods, indications and interpretation of eustachian tube function tests. Ann Otol Rhinol Laryngol 1981;90:552–62Google Scholar
15Teed, RW. Factors producing obstruction of the auditory tube in submarine personnel. US Naval Med Bull 1944;42:293306Google Scholar
16King, PF. The eustachian tube and its significance in flight. J Laryngol Otol 1979;93:659–78Google Scholar
17Felding, JU, Rasmussen, JB, Lildholdt, T. Gas composition of the normal and the ventilated middle ear cavity. Scand J Clin Lab Invest Suppl 1987;186:3141Google Scholar
18Doyle, WJ, Alper, CM, Seroky, JT, Karnavas, WJ. Exchange rates of gases across the tympanic membrane in rhesus monkeys. Acta Otolaryngol 1998;118:567–73Google Scholar
19Johnson, DW. CT of the postsurgical ear. Radiol Clin North Am 1984;22:6775Google Scholar
20Bylander, AKH, Ivarsson, A, Tjernstrom, O, Andreasson, L. Middle ear pressure variations during 24 hours in children. Ann Otol Rhinol Laryngol 1985;94:33–5Google Scholar
21Kanick, SC, Doyle, WJ. Barotrauma during air travel: predictions of a mathematical model. J Appl Physiol 2005;98:1592–602Google Scholar
22Holmquist, J. Middle ear ventilation in chronic otitis media. Arch Otolaryngol 1970;92:617–23Google Scholar
23Shimada, S. Eustachian tube function and mastoid pneumatization. Acta Otolaryngol Suppl 1990;471:51–5Google Scholar
24Diamant, M. Otitis and pneumatization of the mastoid bone. Acta Otolaryngol Suppl 1940;41:1149Google Scholar
25Myerson, MC, Rubin, H, Gilbert, JG. Anatomic studies of the petrous portion of the temporal bone. Arch Otolaryngol 1934;20:193210Google Scholar