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Abstract(s)
Introdução: Apesar do mergulho em apneia ser uma prática com milhares de anos, o seu estudo e o das patologias que daí advêm, nomeadamente na área de otorrinolaringologia, ainda carecem de investigação. No caso da profissão de mariscador, num dia de trabalho um mariscador permanece até 6 horas dentro de água, realizando cerca de 150 a 250 mergulhos, numa profundidade entre 5 a 20 metros, com duração aproximada de 1 a 2 minutos por mergulho. Estando, por isso, durante 6 horas constantemente sujeitos a variações de pressão de, pelo menos, entre os 1 e os 3 atm, onde se dão as variações de volume mais significativas. Apesar de o barotraumatismo do ouvido médio ser o trauma mais comum na prática do mergulho e do barotraumatismo do ouvido interno poder ter repercussões significativas na audição dos mergulhadores, estes são tópicos que carecem de linhas condutoras de diagnóstico e de tratamento, tal como de uma avaliação sistemática e global para o exercício do mergulho em apneia. Caso clínico: Homem de 47 anos, mariscador, com antecedentes de rinite alérgica e sinusite desde há 8 anos, apresenta, durante um mergulho em apneia a 5-6 m de profundidade, quadro súbito de vertigem, seguido de dor aguda e perda auditiva do ouvido esquerdo. Após investigação clínica estabelece-se diagnóstico de barotraumatismo do ouvido médio com ruptura timpânica. Após alta clínica, volta a apresentar episódios de vertigem durante o mergulho, sendo que se investiga possível patologia do ouvido interno. Conclusão: A fisiopatologia do mergulho em apneia, as suas possíveis complicações e seguimento ainda não estão devidamente documentados, principalmente na profissão de mariscadores. É fundamental criar um plano de prevenção e transmitir a importância de um conhecimento mais aprofundado sobre as possíveis patologias, tal como preservar a capacidade de mergulhar, uma vez que tem um impacto significativo na qualidade de vida e capacidade de sustento do doente. Assim, o tratamento neste caso clínico é conservador, com reavaliações periódicas e ênfase na prevenção e atitudes que o doente deve tomar aquando do mergulho.
Introduction: Even though freedive has been a common practice around the world for thousands of years, there is still a lack of knowledge and research on the possible injuries, especially in otorhinolaryngology. In freedive, a fisherman spends, during a work day, in general 6 hours diving, while making a total of 150 to 250 dives, reaching a depth of 5 to 20 meters. Each dive takes 1 to 2 minutes. Hence, during a period of 6 hours, they are submitted to pressure variations between 1 to 3 atm, where the volume changes are the most significant. Although middle ear barotrauma is the most common injury in diving and inner ear barotrauma can have serious repercussions in the diver’s hearing, the guidelines have not yet been clearly defined, especially regarding the diagnosis, the treatment and the assurance that the diver is clear to dive. Case Report: 47-year- old man, freediver, diagnosed with allergic rhinitis and sinusitis for 8 years. He suffered a sudden vertigo, followed by intense pain and hearing loss on the left ear during a freedive at 5-6 meters depth. The consequent clinical investigation diagnosed a middle ear barotrauma with eardrum perforation. After clinical discharge, he once again presented with sudden vertigo while diving. It was investigated an inner ear barotrauma. Conclusion: The physiopathology of freediving, its major complications and the followup are not yet well documented, especially in the profession of seafood divers. It is fundamental to create a prevention plan and to transmit the importance of having a better knowledge about these pathologies, as well as to preserve the ability to dive, since it has an enormous impact on the patient’s livelihood and quality of life. In this case, the treatment was conservatory, with periodic follow-ups and emphasizes in prevention by outlining the necessary safety measures for freediving.
Introduction: Even though freedive has been a common practice around the world for thousands of years, there is still a lack of knowledge and research on the possible injuries, especially in otorhinolaryngology. In freedive, a fisherman spends, during a work day, in general 6 hours diving, while making a total of 150 to 250 dives, reaching a depth of 5 to 20 meters. Each dive takes 1 to 2 minutes. Hence, during a period of 6 hours, they are submitted to pressure variations between 1 to 3 atm, where the volume changes are the most significant. Although middle ear barotrauma is the most common injury in diving and inner ear barotrauma can have serious repercussions in the diver’s hearing, the guidelines have not yet been clearly defined, especially regarding the diagnosis, the treatment and the assurance that the diver is clear to dive. Case Report: 47-year- old man, freediver, diagnosed with allergic rhinitis and sinusitis for 8 years. He suffered a sudden vertigo, followed by intense pain and hearing loss on the left ear during a freedive at 5-6 meters depth. The consequent clinical investigation diagnosed a middle ear barotrauma with eardrum perforation. After clinical discharge, he once again presented with sudden vertigo while diving. It was investigated an inner ear barotrauma. Conclusion: The physiopathology of freediving, its major complications and the followup are not yet well documented, especially in the profession of seafood divers. It is fundamental to create a prevention plan and to transmit the importance of having a better knowledge about these pathologies, as well as to preserve the ability to dive, since it has an enormous impact on the patient’s livelihood and quality of life. In this case, the treatment was conservatory, with periodic follow-ups and emphasizes in prevention by outlining the necessary safety measures for freediving.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Keywords
Mergulho Apneia Barotraumatismo Ouvido médio e interno Otorrinolaringologia