Alternobaric vertigo
| Alternobaric vertigo | |
|---|---|
| Specialty | Otorhinolaryngology, diving medicine  |
In aviation and underwater diving, alternobaric vertigo is dizziness resulting from unequal pressures being exerted between the ears due to one Eustachian tube being less patent than the other.[1][2][3]
Signs and symptoms
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Causes
[edit]This might have occurred due to barotrauma of descent, and/or the effects of nasal decongestants. It is due to unequal increase in middle ear pressures on ascent, is usually mild, and most often cleared by further ascent. When the pressures in both ears reach ambient levels, the stimulus for the dizziness stops.[2] Although most often mild, the vertigo can persist until the diver reaches the surface continuing the unequal pressures, which can damage the inner ear or ear drum.
Alternobaric vertigo is most pronounced when the diver is in the vertical position; the spinning is towards the ear with the higher pressure and tends to develop when the pressures differ by 60 cm of water or more.[4][5] Ear clearing may be a remedy. A similar vertigo can also occur as a result of unequal heating stimulation of one inner ear labyrinth over the other due to diving in a prone position in cold water - the undermost ear being stimulated.
Diagnosis
[edit]In terms of diagnosis for alternobaric vertigo the medical history and physical examination, are important. Furthermore, Eustachian tube function testing is also performed[6]
Treatment Approaches
[edit]- Eustachian Tube Catheterization: For patients with chronic issues related to ETD contributing to ABV, procedures such as Eustachian tube catheterization have been explored as potential treatments. This intervention aims to improve ventilation of the middle ear and restore pressure equilibrium, thereby alleviating symptoms of vertigo
- Interprofessional Management: Effective management of ABV may require a coordinated approach involving primary care physicians, otolaryngologists, and hyperbaric medicine specialists. This multidisciplinary strategy ensures comprehensive evaluation and treatment tailored to individual patient needs, particularly for those with complex presentations involving vestibular dysfunction [7].
Management
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See also
[edit]
- Vertigo – Type of dizziness where a person has the sensation of moving or surrounding objects moving
- Inner ear barotrauma – Pressure injury to the inner ear
- Inner ear decompression sickness – Medical condition caused by inert gas bubbles forming out of solution
References
[edit]- ^ Wicks RE (January 1989). "Alternobaric vertigo: an aeromedical review". Aviat Space Environ Med. 60 (1): 67–72. PMID 2647073.
- ^ a b Tjernström O (December 1974). "Function of the eustachian tubes in divers with a history of alternobaric vertigo". Undersea Biomed Res. 1 (4): 343–51. PMID 4469100. Archived from the original on April 15, 2013. Retrieved 2008-07-04.
{{cite journal}}: CS1 maint: unfit URL (link) - ^ Lundgren CEG, Tjernström O, Ornhagen H (September 1974). "Alternobaric vertigo and hearing disturbances in connection with diving: an epidemiologic study". Undersea Biomed Res. 1 (3): 251–8. PMID 4469094. Archived from the original on July 8, 2010. Retrieved 2008-07-04.
{{cite journal}}: CS1 maint: unfit URL (link) - ^ Edmonds, C. (1971). "Vertigo In Diving". Royal Australian Navy, School of Underwater Medicine. RANSUM-1-71. Archived from the original on July 9, 2010. Retrieved 2008-04-25.
{{cite journal}}: CS1 maint: unfit URL (link) - ^ Ross HE (December 1976). "The direction of apparent movement during transient pressure vertigo". Undersea Biomed Res. 3 (4): 403–10. PMID 10897867. Archived from the original on July 7, 2012. Retrieved 2008-07-04.
{{cite journal}}: CS1 maint: unfit URL (link) - ^ Francescon, Daniel; Cooper, Jeffrey S. (2018). "Diving, Alternobaric Vertigo". StatPearls. StatPearls Publishing. Retrieved 8 December 2018.
- ^ Francescon, Daniel; Jamal, Zohaib; Cooper, Jeffrey S. (2024), "Alternobaric Vertigo", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29489288, retrieved 2024-11-17
