Inner ear decompression sickness and mal de debarquement

Objective: To present a case series of vestibular symptoms appearing after combined sailing and diving activity, and to discuss the differential diagnosis and the workup algorithm. Study Design: Case series. Setting: Tertiary referral center. Patients: Three patients aged 25 to 31 years suffering from unsteadiness and movement sensations after sailing and scuba diving. Interventions: Neurotologic evaluation and recompression therapy in a hyperbaric chamber. Main Outcome Measures: The increasing popularity of marine sports and leisure activities has resulted in the exposure of a growing number of people to unique abnormalities not encountered under terrestrial conditions. The otolaryngologist who is involved in the care of these patients is required to diagnose and treat diving-related sinus and ear injuries such as barotrauma and decompression sickness, and also to be familiar with sailing-related disorientation syndromes such as seasickness and mal de debarquement. Treatment modalities for the various abnormalities differ significantly, and early commencement of treatment is often crucial for a successful outcome. Conclusion: Whenever doubt exists, recompression treatment must be instituted as soon as possible because of the potential for severe sequelae if the patient is left untreated, and because the risks involved in this therapy are minimal.