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Recurrent Inner Ear Decompression Sickness Associated With a Patent Foramen Ovale
Christoph Klingmann, MD;
Michael Knauth, MD;
Stefan Ries, MD;
Rolf Kern, MD;
Abel-Jan Tasman, MD
Arch Otolaryngol Head Neck Surg. 2002;128:586-588.
Isolated inner ear injuries occurring during shallow scuba dives are
an uncommon manifestation of decompression sickness in recreational divers.
We describe a patient who presented with the typical symptoms of inner ear
involvement after 2 independent dives within the decompression limits. The
diver reported symptoms of unilateral (right-sided) hearing loss, tinnitus,
and vertigo after dives to 35 and 50 m. After treatment with hyperbaric oxygen,
his symptoms completely resolved. To confirm the hypothesis of inner ear decompression
sickness (IEDCS), we examined the patient for a right-to-left shunt by cranial
Doppler ultrasound and found a patent foramen ovale. The existence of a patent
foramen ovale is suspected to be a risk factor for developing neurological
symptoms of decompression sickness. There was no evidence of any other risk
factors, so we suggest that the relevant right-to-left shunt in our patient
may have been the predisposing factor that caused the inner ear symptoms during
his scuba dive.
From the Departments of Ear, Nose, and Throat Surgery (Drs Klingmann
and Tasman) and Neuroradiology (Dr Knauth), Klinikum Heidelberg, University
of Heidelberg, Heidelberg, Germany, and the Department of Neurology, Klinikum
Mannheim, University of Heidelberg, Mannheim, Germany (Drs Ries and Kern).
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