A pilot study evaluating surfactant on eustachian tube function in divers

Military Medicine
Christopher DuplessisDerek Schwaller

Abstract

Middle ear barotrauma (MEBT) is the most common medical complication in diving, aviation, and hyperbaric medicine. Eustachian tube dysfunction (ETD) quantifies the inability to open the eustachian tube (ET), risking MEBT. Surfactant administration improved ET function and efficaciously treated otitis media in a host of animal models. We performed a pilot study evaluating the efficacy of intranasal surfactant administration in reducing MEBT in repetitive diving. Eight divers participated in a subject-blinded, placebo-controlled, random order, multiarm (air and O2)-repeated measures trial investigating the relative efficacy of intranasally administered surfactant, acetylcysteine and oxymetazoline, and orally administered pseudoephedrine versus saline-placebo in middle ear equilibration during repetitive, multiday diving. Subjects were tested with the Nine-Step Inflation/Deflation Tympanometry Test (NSI/DT) and sonotubometry (testing eustachian tube opening pressure [ETOP]) before and immediately after each dive. Significant interaction effects were found for drug-by-test (F8,668 = 4.05; p < 0.001) and the three-way interaction of drug-by-dive-by-test (F16,668 = 2.47; p = 0.001) in sonotubometry testing. The ETOP revealed trends t...Continue Reading

Citations

May 6, 2014·Expert Opinion on Pharmacotherapy·Nicole M Thomas, Itzhak Brook
Jan 16, 2015·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Moritz F MeyerDirk Beutner
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Aug 4, 2021·The South African Journal of Communication Disorders. Die Suid-Afrikaanse Tydskrif Vir Kommunikasieafwykings·Aimee Flowers, Dhanashree Pillay

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