{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:10:52Z","timestamp":1784157052238,"version":"3.55.0"},"reference-count":0,"publisher":"Diving and Hyperbaric Medicine Journal","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diving Hyperb Med"],"abstract":"<jats:p>Introduction: Inner ear barotrauma (IEBt) and inner ear decompression sickness (IEDCS) are the two dysbaric inner ear\ninjuries associated with diving. Both conditions manifest as cochleovestibular symptoms, causing difficulties in differential\ndiagnosis and possibly delaying (or leading to inappropriate) treatment.\nMethods: This was a systematic review of IEBt and IEDCS cases aiming to define diving and clinical variables that help\ndifferentiate these conditions. The search strategy consisted of a preliminary search, followed by a systematic search\ncovering three databases (PubMed, Medline, Scopus). Studies were included when published in English and adequately\nreporting one or more IEBt or IEDCS patients in diving. Concerns regarding missing and duplicate data were minimised\nby contacting original authors when necessary.\nResults: In total, 25 studies with IEBt patients (n = 183) and 18 studies with IEDCS patients (n = 397) were included.\nVariables most useful in differentiating between IEBt and IEDCS were dive type (free diving versus scuba diving), dive\ngas (compressed air versus mixed gas), dive profile (mean depth 13 versus 43 metres of seawater), symptom onset (when\ndescending versus when ascending or surfacing), distribution of cochleovestibular symptoms (vestibular versus cochlear)\nand absence or presence of other DCS symptoms. Symptoms of difficult middle ear equalisation or findings consistent with\nmiddle ear barotrauma could not be reliably assessed in this context, being insufficiently reported in the IEDCS literature.\nConclusions: There are multiple useful variables to help distinguish IEBt from IEDCS. Symptoms of difficult middle ear\nequalisation or findings consistent with middle ear barotrauma require further study as means of distinguishing IEBt and\nIEDCS.<\/jats:p>","DOI":"10.28920\/dhm51.4.328-337","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T21:14:52Z","timestamp":1639430092000},"page":"328-337","source":"Crossref","is-referenced-by-count":11,"title":["Inner ear barotrauma and inner ear decompression sickness: a systematic review on differential diagnostics"],"prefix":"10.28920","volume":"51","author":[{"given":"Oskari H","family":"Lindfors","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Head and Neck Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne K","family":"R\u00e4is\u00e4nen-Sokolowski","sequence":"additional","affiliation":[{"name":"Department of Pathology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland, Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo P","family":"Hirvonen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Head and Neck Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saku T","family":"Sinkkonen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery, Head and Neck Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11463","published-online":{"date-parts":[[2021,12,20]]},"container-title":["Diving and Hyperbaric Medicine Journal"],"original-title":[],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T02:42:23Z","timestamp":1782182543000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.dhmjournal.com\/images\/IndividArticles\/51Dec\/Lindfors_InEarBarotrauma_2021-33(816).pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,20]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,12,20]]}},"URL":"https:\/\/doi.org\/10.28920\/dhm51.4.328-337","relation":{},"ISSN":["2209-1491"],"issn-type":[{"value":"2209-1491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,20]]}}}