{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:10:50Z","timestamp":1784157050179,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T00:00:00Z","timestamp":1550448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Introduce pertinent self\u2010contained underwater breathing apparatus (SCUBA) physiology and corresponding terminology. Appreciate the scope of diving and related otolaryngological injury. Illustrate pathophysiologic mechanisms for diving injuries. Summarize strategies for ear, paranasal sinus, and lung barotrauma prevention, including medical optimization and autoinsufflation techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a review of the available medical and diving literature in English, German, Spanish, Italian Turkish, and French to determine the degree of evidence or lack thereof behind recommendations for treating SCUBA divers. The databases of PubMed, Ovid Medline, and the Cochrane library, as well available textbooks, were queried for relevant data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Divers are subjected to large pressure gradients within the first few meters of descent. This can lead to gas embolism formation as well as barotrauma secondary to gas expansion\/compression in potential closed spaces such as the middle ear, paranasal sinuses, and lungs. Physicians can minimize the risk of injury by counseling patients regarding proper equalization and descent\/ascent techniques, and optimizing sinonasal and eustachian tube function. The use of decongestants is controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diving is an increasingly popular sport with predominantly otolaryngologic manifestations of injury and disease. Treating SCUBA divers requires a firm understanding of how physiology is altered underwater. This review presents the relevant background information using illustrations to understand the environmental forces acting on divers and how to prevent injury. <jats:italic>Laryngoscope<\/jats:italic>, 130:52\u201358, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27867","type":"journal-article","created":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T15:34:46Z","timestamp":1550504086000},"page":"52-58","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["SCUBA Medicine for otolaryngologists: Part I. Diving into SCUBA physiology and injury prevention"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-2454","authenticated-orcid":false,"given":"Jonathan R.","family":"Mallen","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology University of Connecticut Health  Farmington Connecticut U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology University of Connecticut Health  Farmington Connecticut U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,18]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"McAniffJ.An analysis of recreational technical and occupational populations and fatality rates in the United States 1970\u20101994. 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Published July 1995."},{"key":"e_1_2_5_3_1","first-page":"401","article-title":"Otorhinolaryngologic aspects of diving sports [in German]","volume":"41","author":"Strutz J","year":"1993","journal-title":"HNO"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-007-1635-4"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1201\/b18700"},{"key":"e_1_2_5_6_1","volume-title":"Effects of Diving on the Human Cochleovestibular System","author":"Molvaer OI"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000235373.78116.a8"},{"key":"e_1_2_5_8_1","first-page":"175","article-title":"Risk of decompression sickness with patent foramen ovale","volume":"25","author":"Bove AA","year":"1998","journal-title":"Undersea Hyperb 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