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26.07.2014

Ear ringing hearing loss pressure, insomnia disorder test - PDF Review

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Barotrauma refers to injury sustained from failure to equalize the pressure of an air-containing space with that of the surrounding environment. Barotrauma can affect several different areas of the body, including the ear, face and lungs. Inner ear decompression sickness (IEDCS) is an injury that closely resembles inner ear barotrauma; however, the treatment is different.
Barotrauma is caused by a difference in pressure between the external environment and the internal parts of the ear.
The outer ear is an air-containing space that can be affected by changes in ambient pressure (see Figure 1). The most common problem that occurs in diving and flying is the failure to equalize pressure between the middle ear and the ambient environment (see Figure 2).
As a diver descends to only 2.6 feet with difficulty equalizing the pressure of his middle ear space, the tympanic membrane and ossicles are retracted, and the diver experiences pressure and pain (see Figure 3).
Inner ear injury during descent is directly related to impaired ability to equalize the middle ear pressure on the affected side. The implosive mechanism theory (see Figure 4) involves clearing of the middle ear during descent. The explosive theory (see Figure 5) suggests that when a diver attempts to clear a blocked middle ear space by performing a Politzer maneuver and the eustachian tube is blocked and locked, a dramatic increase in the intracranial pressure occurs.
For outer ear barotrauma, the treatment consists of clearing the ear canal of the obstruction, and restricting diving or flying until the blockage is corrected and the ear canal and drum return to normal. For middle ear barotrauma, treatment consists of keeping the ear dry and free of contamination that could cause infection.
Prevention of air barotraumas to the middle ear has been attempted with dasal decongestants or vasoconstrictors with mixed results.
For inner ear barotrauma, treatment consists of hospitalization and bed rest with the head elevated 30 to 40 degrees. If barotrauma results from diving, you should not to return to diving until your ear examination is normal, including a hearing test and the demonstration that the middle ear can be autoinflated. The American Hearing Research Foundation is a non-profit foundation that funds research into hearing loss and balance disorders related to the inner ear, and to educating the public about these health issues.
Ongoing Exposure to Noise on the JobLong-term exposure to continuous loud noise can cause lasting hearing loss. It is caused by a difference in pressure between the two middle ear spaces, which stimulates the vestibular (balance) end organs asymmetrically, thus resulting in vertigo.


Since fluids do not compress under pressures experienced during diving or flying, the fluid-containing spaces of the ear do not alter their volume under these pressure changes.
Equalization of pressure occurs through the eustachian tube, which is the soft tissue tube that extends from the back of the nose to the middle ear space.
Sudden, large pressure changes in the middle ear can be transmitted to the inner ear, resulting in damage to the delicate mechanisms of the inner ear.
The pressure is transmitted from an inward bulging eardrum, causing the ossicles to be moved toward the inner ear at the oval window. Since the fluids surrounding the brain communicate freely with the inner ear fluids, this pressure may be transmitted to the inner ear. If the history indicates ear pain or dizziness that occurs after diving or an airplane flight, barotrauma should be suspected. At the American Hearing Research Foundation (AHRF), we have funded basic research on barotrauma in the past, and are interested in funding sound research on barotrauma in the future. Although the degree of pressure changes are much more dramatic during scuba diving, barotraumatic injury is possible during air travel. The alternobaric response can also be elicited by forcefully equalizing the middle ear pressure with the Politzer maneuver, which can cause an unequal inflation of the middle ear space.
However, the air-containing spaces of the ear do compress, resulting in damage to the ear if the alterations in ambient pressure cannot be equalized.
An obstruction such as wax, a bony growth, or earplugs can create an air-containing space that can change in volume in response to changes in ambient pressure. This pressure wave is transmitted through the inner ear and causes an outward bulging of the other window, the round window membrane. A sudden rise in the inner ear pressure could then cause the round or oval window membrane to explode. The diagnosis may be confirmed through ear examination, as well as hearing and vestibular testing. A trial evaluating the effect of these earplugs found them to have no effect on eustachain tube function (Jumah et al 2010). Once healed, a diver should not return to diving until hearing and balance function tests are normal.
Pressure-equalizing earplugs do not prevent barotrauma on descent from 8000 ft cabin altitude. During descent, the volume of this space decreases causing the tympanic membrane to bulge outward (toward the outer ear canal).


If a diver performs a forceful Politzer maneuver and the eustachian tube suddenly opens, a rapid increase in middle ear pressure occurs. If the eustachian tube demonstrates chronic problems with middle ear equalization, the likelihood of recovery is drastically reduced.
Injury or Pressure ChangesSevere head trauma can dislocate middle-ear bones or cause nerve damage, causing permanent hearing loss. Sudden changes in pressure -- from flying or scuba diving -- can lead to damage to the eardrum, middle ear, or inner ear and hearing loss. Chronic DiseaseCertain chronic diseases that are not directly related to the ear can cause hearing loss. Autoimmune diseases, such as rheumatoid arthritis, also can be linked to some forms of hearing loss.
How You Hear -- Anatomy of the EarSound waves enter the outer ear and travel through the ear canal. This causes the eardrum and tiny bones, called the hammer and anvil, in the middle ear to vibrate.
Tumors and GrowthsNoncancerous growths, including osteomas, exostoses, and benign polyps, can block the ear canal, causing hearing loss. Acoustic neuroma (an inner ear tumor shown here), grows on the hearing and balance nerve in the inner ear.
For more hearing loss information from WebMD, click "Next." Childhood IllnessMany childhood illnesses can cause hearing loss.
Ear infections can cause the middle ear to fill with fluid and cause hearing loss that usually clears when the infection and fluid are gone. Diseases known to affect hearing in children include chickenpox, encephalitis, influenza, measles, meningitis, and mumps. Though congenital hearing loss often runs in families, it can occur with maternal diabetes or an infection when pregnant. Hearing loss can also develop if a newborn is premature or from other causes such as trauma during birth resulting in the infant not getting enough oxygen. Usually, age-related hearing loss is caused by the progressive loss of inner-ear hair cells.



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