Alternobaric vertigo

Alternobaric vertigo
Specialty	Otorhinolaryngology, diving medicine

In aviation and underwater diving, alternobaric vertigo is dizziness resulting from unequal pressures being exerted between the ears due to one Eustachian tube being less patent than the other.

Causes

This might have occurred due to barotrauma of descent, and/or the effects of nasal decongestants. It is due to unequal increase in middle ear pressures on ascent, is usually mild, and most often cleared by further ascent. When the pressures in both ears reach ambient levels, the stimulus for the dizziness stops. Although most often mild, the vertigo can persist until the diver reaches the surface continuing the unequal pressures, which can damage the inner ear or ear drum.

Alternobaric vertigo is most pronounced when the diver is in the vertical position; the spinning is towards the ear with the higher pressure and tends to develop when the pressures differ by 60 cm of water or more. Ear clearing may be a remedy. A similar vertigo can also occur as a result of unequal heating stimulation of one inner ear labyrinth over the other due to diving in a prone position in cold water - the undermost ear being stimulated.

Diagnosis

In terms of diagnosis for alternobaric vertigo the medical history and physical examination, are important. Furthermore, Eustachian tube function testing is also performed

Treatment Approaches

• Eustachian Tube Catheterization: For patients with chronic issues related to ETD contributing to ABV, procedures such as Eustachian tube catheterization have been explored as potential treatments. This intervention aims to improve ventilation of the middle ear and restore pressure equilibrium, thereby alleviating symptoms of vertigo
• Interprofessional Management: Effective management of ABV may require a coordinated approach involving primary care physicians, otolaryngologists, and hyperbaric medicine specialists. This multidisciplinary strategy ensures comprehensive evaluation and treatment tailored to individual patient needs, particularly for those with complex presentations involving vestibular dysfunction .

See also

• Vertigo – Type of dizziness where a person has the sensation of moving or surrounding objects moving
• Inner ear barotrauma – Pressure injury to the inner ear
• Inner ear decompression sickness – Medical condition caused by inert gas bubbles forming out of solution