Hyperbaric oxygen therapy caused tympanic membrane and ventricular hemorrhage: a case report

A 40-year-old male undergoing rehabilitation with hyperbaric oxygen therapy (HBOT) three months after an acute right frontal lobe cerebral infarction. On the second day of HBOT, he felt a significant blockage and pain in his left ear during and after the treatment. The endoscopic assessment of the ear and nose revealed haemorrhage in the left ear tympanic membrane and hemorrhagic effusion in the tympanic chamber. The nasal septum was found to be left deviated resulting in significant narrowing of the left nasal cavity and significant poor ventilation. Laboratory tests showed normal blood count and normal blood coagulation count. The final diagnosis of haemorrhage and fluid accumulation in the tympanic chamber of the left ear was made. After the treatment of the middle ear ball blowing once a day for 10 days, the pure tone audiometry of the left ear reached the level of the right ear, and the blockage and pain in the left ear disappeared completely. The orthoscopy inspection indicated total absorption of hemorrhagic fluid in the tympanic chamber of the left ear. This is the first report that HBOT caused tympanic membrane haemorrhage and offers new insights into the prevention of comorbidities in HBOT.