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Objective: Sudden sensorineural hearing loss in divers may be caused by either inner-ear barotrauma or inner-ear decompression sickness. There is no consensus on the best treatment option. This study aimed to evaluate the therapeutic value of hyperbaric oxygen therapy for sudden sensorineural hearing loss in divers., Method: A literature review and three cases of divers with sudden sensorineural hearing loss treated with hyperbaric oxygen therapy are presented., Results: Hyperbaric oxygen therapy resulted in hearing improvement in 80 per cent of patients: 39 per cent had hearing improvement and 41 per cent had full recovery., Conclusion: Hyperbaric oxygen therapy improved hearing in divers with sudden sensorineural hearing loss.

Objective: We report three cases of recurrent, unilateral facial palsy associated with air travel., Method: The three cases are presented, along with a brief literature review concerning barotrauma and its association with air travel and facial palsy., Results: All three patients experienced unilateral facial paralysis during air travel, accompanied by additional symptoms which varied between cases. Symptoms resolved spontaneously in all cases. Two patients received ventilation tube insertion to prevent further recurrence. Computed tomography scanning revealed no bony defect in two patients, while the third exhibited dehiscence of the facial canal which may have contributed to the condition., Conclusion: Available evidence suggests that eustachian tube dysfunction can contribute to increased pressure within the middle ear, leading to neuropraxia of the facial nerve. Cases of facial paralysis associated with air travel are under-reported. Since there is no evidence-based management protocol for this condition, further investigation of its pathology is encouraged in order to improve our understanding.

Background: People suffer unique health problems in high altitude areas, due to such factors as elevation, aircraft ascent and descent, extreme cold, hypoxia, hypobaria, and low relative humidity. This study was conducted to evaluate ENT morbidity at high altitude., Methods: Serving soldiers introduced to a high altitude environment who presented with various ENT symptoms were examined to identify ENT disease. In addition, patients undergoing hyperbaric chamber therapy, tracheostomy and treatment of cold injuries were also examined for ENT problems., Results: The following were detected: 13 cases of otic barotrauma, 11 cases of sinus barotrauma, three cases of vertigo, six cases of pinna frostbite, three cases of barotrauma caused by hyperbaric chamber therapy, an unusually high incidence of epistaxis, and innumerable patients with high altitude pharyngitis., Conclusion: Diseases of the ear, nose and throat contribute significantly to high altitude morbidity. In a military context, health education of troops is necessary to avoid such problems.

Objectives: To report a rare presentation of dehiscent infraorbital canal associated with a maxillary antral cyst., Case Report: A 26-year-old woman presented with symptoms of right infraorbital nerve dysfunction experienced while travelling by aeroplane. She was subsequently diagnosed with dehiscent infraorbital canal and large maxillary antral cyst on computed tomography scanning. The cyst was removed by endoscopic sinus surgery, and the patient's symptoms resolved., Discussion: The effects of barotrauma on the ears and paranasal sinuses are reviewed. This is the first report of infraorbital nerve dysfunction caused by altered atmospheric pressure in the presence of dehiscent infraorbital canal and maxillary antral cyst. Endoscopic sinus surgery was successful in relieving the symptoms in this case.

A facial nerve palsy, as a result of middle-ear high pressure, is a rare complication of sub-aqua diving. It may occur as a result of an acute pressure change in the middle ear during ascent in those patients who have experienced difficulty equalizing their middle-ear pressure during the prior descent. We present the case history of this occurring in a 21-year-old diver and discuss the pathophysiology, management and the previous literature. The correct diagnosis of this condition is important if unnecessary, and potentially hazardous, recompression treatment is to be avoided.

A 20-year-old woman developed gross surgical emphysema tracking down to the chest after an episode of nose blowing. Fortunately there were no ocular complications and the patient settled with conservative management. Follow-up showed no recurrence. The case presented illustrates the very rare complication of orbital fracture following nose blowing.

Controversies of how best to treat fresh tympanic membrane perforations have always existed. While some otolaryngologists prefer the paper patch method, others prefer modified myringoplasty. A prospective study is needed to investigate the most effective and least expensive management of this common ear trauma. This study examined prospectively, in three sections, a group of patients with a cellophane patch (n = 6), another group with a gentamicin ointment seal (n = 15) and a control group (n = 9) with a gentamicin plug placed at the distal end of the external auditory cavity. Successful healing of the traumatic tympanic membrane perforations was achieved in 50 per cent of the cellophane seal group, 86.7 per cent of the gentamicin ointment seal group and 77.8 per cent of the control group. This study shows that the management of a fresh tympanic membrane perforation should be limited to cleaning the traumatized ear and preventing infection.

We report a case of a patient who experienced transient recurrent facial nerve palsies during flights on commercial aeroplanes. Although this condition is well recognized in divers, only six cases have been reported to occur on flying. The pathophysiology of this condition is discussed.