Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement.

Fiesseler F.W., Silverman M.E., Riggs R.L., Szucs P.A. Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement. Undersea Hyperb Med 2006; 33(4):231-235. Introduction: Hyperbaric oxygen therapy (HBO2) has been utilized for many years for a multitude of disease entities. One commonly encountered side-effect is otic barotrauma. Objective: To determine if patients with specific disease processes are at increased risk of requiring tympanostomy tubes during HBO2. Methods: Data was obtained from Jan. 2000 to Dec. 2004, retrospectively. The requirement for tympanostomy tubes during a course of HBO2 was established. Results: 325 met inclusion criteria. Fifteen percent of patients overall (95% CI= 11-19%) required tympanostomy tubes. Tubes were required in: 5% necrotizing soft tissue infection (p=0.33); 10% failed/threatened graft (p=0.39); 15% problem wounds; 17% chronic refractory osteomyelitis (CRO) (p=0.64); 22% soft tissue radionecrosis (STRN)/ osteoradionecrosis (ORN) (p=0.02); 33% of crush injuries (p=0.10). Twenty-nine percent of nasopharyngeal radiation injury patients (p=0.001) and 10% of the non-nasopharyngeal radiation patients (p=0.36) received tympanostomy tubes. Conclusion: A significant increase in tympanostomy tubes were required in nasopharyngeal radiation injury patients.