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Hyperbaric Oxygen Therapy (HOT) encompasses an extensive research area in which new indications, some of which are now well-codified, have emerged both in the fields of medical and surgical pathology. Its utilization in carefully targeted clinical situations, in which its true efficacy can be demonstrated, is first of all connected with medicolegal responsibility, in suspected iatrogenic accidents; its application must furthermore be subordinated to a favourable cost/benefit ratio for the health service employing it. In otorhinolaryngology and head and neck surgery, HOT is a strategic therapeutic weapon in several applications. Its most widely recognized indications are radiation lesions, chronic osteomyelitis of the mandible, head and neck infections, malignant external otitis, sudden hypoacusia, chronic tinnitus, encephalitis, treatment of the gasseous embolus, skin grafts, vascularized flaps, cervicoencephalic traumas. HOT indications as a radiosensitizing and/or chemiosensitizing factor are still being studied. Both a review of the literature and our experience appear, beyond any doubt, to confirm that HOT promotes faster recovery and reduces hospital stays, thus qualifying as a new therapeutic aid that complements the usual well-established methods.

The aim of the present work was to check the results obtained in a group of patients suffering from otological pathologies who had undergone day surgery. In addition, to determine the reliability and validity of this form of out-patient surgery in otology, complications were compared with a similar group of patients who had undergone surgery under normal hospital in-patient conditions. The study only viewed patients hospitalized for otological pathologies from January 1995 to April 1998. During this period of time 90 patients with varying degrees of otological pathologies underwent out-patient day surgery. This surgical activity was then compared to the same type of surgery performed under normal in-patient hospitalization. During the post-operative phase of day surgery, only 7 patients (7.7%) had to be fully hospitalized: 5 complaining of dizziness, the other 2 with fever that ruled out discharge in the evening. In all cases, after hospitalization for the night the patient could be safely discharged. In the normally hospitalized in-patients, complications arose in 14 cases (8.6%) with fever being the most common complication (8 patients). On the basis of the results, it appears that nearly all otological pathologies can be treated in day surgery. This solution limits complications and ensures good economic management; it results in savings and improved organization, reduces the waiting lists and rationalizes use of the operating rooms. Moreover, it must be pointed out that the program was highly appreciated by the patients who could better schedule their own activities, both work and social-family obligations. This aspect is quite important in view of a broader outlook on the economics of the national health system as it shows a savings, not only in the health costs, but also in the overall labor costs.