Prevention of otic barotrauma in aviation: a systematic review

Peter Ryan, Alexander Treble, Nirmal Patel, Nicholas Jufas

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Objective: To conduct a systematic review of the published evidence relating to the prevention of otic barotrauma in aviation. In particular, this review sought to identify procedures, techniques, devices, and medications for the prevention of otic barotrauma as well as evaluate the evidence relating to their efficacy. Data Sources: Ten databases including Embase, MEDLINE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched using the full historical range. Study Selection: English language articles including more than or equal to five participants or cases were included. Outcomes of interest were reduced severity or the successful prevention of otic barotrauma in participants undergoing gradual changes in pressure during air travel or its simulation. Data Extraction: Articles and data were extracted and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses and other international guidelines. Conclusions: This review highlights the lack of published evidence relating to what is a significant and increasingly common problem in otology. There is level 1 evidence that supports the efficacy of oral pseudoephedrine (120 mg) in preventing otic barotrauma in adults. However, oral pseudoephedrine (1 mg/kg) does not appear to be effective in children. There is insufficient evidence to support the efficacy of either nasal balloon inflation or pressure-equalizing ear plugs for the prevention of otic barotrauma. A recently reported, novel technique for insertion of temporary tympanostomy tubes is promising but requires further evaluation.

LanguageEnglish
Pages539-549
Number of pages11
JournalOtology and Neurotology
Volume39
Issue number5
DOIs
Publication statusPublished - 1 Jun 2018

Fingerprint

Barotrauma
Aviation
Ear
Pseudoephedrine
Air Travel
Databases
Middle Ear Ventilation
Pressure
Information Storage and Retrieval
Economic Inflation
Otolaryngology
Nose
MEDLINE
Meta-Analysis
Language
Guidelines
Equipment and Supplies

Keywords

  • Aviation
  • Barotrauma
  • Middle ear
  • Otic barotrauma
  • Tympanic membrane

Cite this

Ryan, Peter ; Treble, Alexander ; Patel, Nirmal ; Jufas, Nicholas. / Prevention of otic barotrauma in aviation : a systematic review. In: Otology and Neurotology. 2018 ; Vol. 39, No. 5. pp. 539-549.
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Prevention of otic barotrauma in aviation : a systematic review. / Ryan, Peter; Treble, Alexander; Patel, Nirmal; Jufas, Nicholas.

In: Otology and Neurotology, Vol. 39, No. 5, 01.06.2018, p. 539-549.

Research output: Contribution to journalReview articleResearchpeer-review

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