Therefore, early diagnosis and differential diagnosis are important to relieve early symptoms and prevent disease progression. This situation may lead to a misdiagnosis and/or delay in diagnosis and treatment. Patients with CO- poisoning and with reduced sensory and cognitive function may have no or slight symptoms of otic and sinus barotrauma after HBO therapy. The treatments depend on the symptoms and clinical examinations, such as temporary cessation of HBO therapy and the use of decongestants and antibiotics occasionally, functional middle ear or sinus surgery is needed –. Sinus barotrauma can cause headache, pain and fullness in the sinuses.The diagnosis is based on symptoms and otoscopy or rhinoscopy. Otic barotrauma can cause many discomforts, such as tinnitus, hearing loss, pain and fullness in the sinus and middle ear, and even tympanic membrane perforation. When the eustachian tube or sinus ostia is blocked or the pressure change exceeds the capacity of its regulation, otic and sinus barotrauma occurs –. Under normal conditions, the eustachian tube must open to eliminate the pressure difference between the internal and ambient environments. Otic barotrauma is one of the most common barotraumas after HBO therapy and is sometimes accompanied by sinus barotraumas –. Pressure changes can affect the ears, the sinuses, and the lungs, resulting in injury. According to Boyle’s law, a primary change in environmental pressure results in an inverse change in volume. Barotrauma is defined as tissue damage resulting from the direct effects of pressure –. Although patients with CO-poisoning could benefit from the therapy, the side effects, such as barotrauma, should not be overlooked. It is useful to decrease the incidence of delayed neuropsychologic sequelae in patients with CO-poisoning –.
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