E-ISSN 2602-4837
The Turkish Journal of Ear Nose and Throat The predictive value of assessing mastoid pneumatization in pre-dive examinations [Tr-ENT]
Tr-ENT. 2005; 15(2): 56-61

The predictive value of assessing mastoid pneumatization in pre-dive examinations

Cem Uzun1, Abdullah Taş, Recep Yağız, Mustafa K. Adalı, Muhsin Koten, Haldun Şan, Ahmet R. Karasalihoğlu

Objectives: We investigated the value of assessing the
degree of mastoid pneumatization in predicting middle ear
barotrauma -the most common problem in sport SCUBA
divers- in comparison with that of the conventional predive
examination method, the Valsalva maneuver.
Materials and Methods: Thirty-four volunteer sport
SCUBA divers having normal pre-dive examination findings
were included. The Valsalva test was performed in all
the divers. Mastoid pneumatization for each ear was calculated
on a Schuller’s view radiography. Pneumatization
of ≤30 cm2 was accepted as poor (prone to barotrauma)
and >30 cm2 was accepted as good (not prone to barotrauma).
During the observation period, the divers were
monitored with regard to barotrauma symptoms or signs.
Results: The degree of mastoid pneumatization was ≤30 cm2
in 26 ears (38%) of 16 divers (47%). The Valsalva test was
negative in eight ears (12%) of six divers (18%). During a
total of 1001 dives, symptomatic middle ear barotrauma
occurred in 28 dives (2.8%), i.e. in 21 ears (31%) of 16 divers
(47%). Of these, the degree of mastoid pneumatization predicted
barotrauma in 11 (69%) divers, whereas the Valsalva
test was negative in only three (19%) (p<0.05), with sensitivity,
specificity, positive and negative predictive values, and
efficiency being 69% and 19%, 72% and 83%, 69% and
50%, 72% and 54%, and 71% and 53%, respectively.
Conclusion: The value of assessing mastoid pneumatization
in predicting middle ear barotrauma in sport
SCUBA divers is higher than that of the Valsalva test.

Keywords: Barotrauma/diagnosis; diving/adverse effects; mastoid;middle ear ventilation; predictive value of tests; Valsalva maneuver.

Dalıcı muayenesinde mastoid pnömatizasyon derecesinin barotravmayı öngörmedeki değeri

Cem Uzun1, Abdullah Taş, Recep Yağız, Mustafa K. Adalı, Muhsin Koten, Haldun Şan, Ahmet R. Karasalihoğlu

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Anahtar Kelimeler: Barotravma/tanı; dalıcılık/yan etki; mastoid; ortakulak ventilasyonu; test öngördürücü değeri; Valsalva manevrası.

Cem Uzun, Abdullah Taş, Recep Yağız, Mustafa K. Adalı, Muhsin Koten, Haldun Şan, Ahmet R. Karasalihoğlu. The predictive value of assessing mastoid pneumatization in pre-dive examinations. Tr-ENT. 2005; 15(2): 56-61

Corresponding Author: Cem Uzun
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