Introduction/Background: Otic barotrauma from Eustachian tube dysfunction is the most common complication related to hyperbaric treatments. Tympanostomy tubes have long been placed in patients who are unable to equalize the middle ear while undergoing hyperbaric treatments. This requires evaluation by an otolaryngologist, which can delay hyperbaric treatments. Myringotomies performed by the HBO2 provider are an alternative option. A concern with this procedure is premature myringotomy site closure requiring repeat myringotomies or tympanostomy tube placement resulting in further patient discomfort and possible complications. A possible solution is to use a mucosal atomizer device to gently infuse the myringotomy site with air to maintain patency, which has become the standard of care at HCMC. However, the effectiveness of this method to maintain myringotomy patency has not previously been studied Materials and Methods: Patients who are undergoing bilateral myringotomies will be randomly assigned to use a mucosal atomizer device in a randomly assigned ear. This will allow for a self-control scenario with the contralateral ear acting as the control. Randomization will occur using a random number generator with continuous enrollment. Patients will use a mucosal atomizer device prior to each hyperbaric oxygen treatment. Patients will be evaluated routinely for myringotomy patency with planned examination 15, 30, 45, 60 and 90 days after the myringotomies are performed to evaluate patency.
Results: Study parameters to be measured:
● Primary outcome: Myringotomy patency
● Need to repeat myringotomy
● The number of hyperbaric treatments in which the patient has ear pain or requires any stops during compression.
● Any demonstrable otic barotrauma on exam (with TEED score).