[Internal ear injuries in diving: apropos of 16 cases]. / Accidents d'oreille interne en plongée sous marine: a propos de 16 cas.

After the study of 16 observations of inner ear injuries in diving, the authors remind us to the different mechanisms of inner ear's lesions. The principle of treatment depends of these mechanisms. Emergency is to recognize a decompression injury. So, all vestibular disorders must be considered as a decompression injury, as soon as, it was a saturating diving. Hyperbaric oxygenotherapy must be undertaken immediately. Though the symptomatology suggestive of fistula for 4 patients, no surgical exploration was done. The follow-up was marked by spontaneous amelioration, that make think of possible spontaneous cicatrization.

[Incidence of vertigo in diving]. / Incidence des vertiges en plongée sous marine.

Vertigo is relatively common after diving. Although it may be the result of the changes in pressure, it can also be a feature of decompression accidents, of clinical toxicity, simply be a manifestation of altered physiology resulting from immersion in a weightless environment in which all the organs involved in maintaining equilibrium (vestibular system, proprioception and vision) are affected. It seemed to us to be of interest to study the incidence of vertigo in naval divers by means of an anonymous questionnaire. The responses were elicited over a 3 month period from 333 divers. 45 divers reported clinical sensations of vertigo, an incidence of 13.5%. If this figure is related to the number of dives, the incidence falls to 0.06%. No decompression accidents were reported. The main aetiology was barotrauma, 42% being of alternobaric and 36% of pressure type. The remaining aetiologies were sensory illusions in 6% of cases, and other non-ENT causes in 16%. After a review of the physiopatholgy and study of the case hisotries, there is a discussion of the features which allow the aetiology to be determined and treatment planned.

Optokinetic stimulation rehabilitation in preventing seasickness.

OBJECTIVES: Seasickness occurs when traveling on a boat: symptoms such as vomiting are very disturbing and may be responsible for discontinuing travel or occupation and can become life-threatening. The failure of classical treatment to prevent seasickness has motivated this retrospective study exploring optokinetic stimulation in reducing these symptoms. PATIENTS AND METHODS: Experimental training of 75 sailors with optokinetic stimulation attempted to reduce seasickness manifestations and determine the factors that could predict accommodation problems. RESULTS: Eighty percent of the trained subjects were able to return on board. No predictive factors such as sex, occupation, degree of illness, number of treatment sessions, time to follow-up, and age were found to influence training efficacy. CONCLUSION: Optokinetic stimulation appears to be promising in the treatment of seasickness. Nevertheless, statistically significant results have yet to demonstrate its efficacy.