![]() ![]() The middle ear space is covered by mucosa and is connected to the throat via the eustachian tube (ET), also referred to as the auditory tube. The vestibular system, which is continuous with the cochlea, is responsible for spatial orientation and balance. The cochlea is responsible for sound transmission and is composed of three fluid-filled compartments: the scala vestibuli and scala tympani containing perilymph and the scale media containing endolymph. ![]() The inner ear space, containing the auditory (cochlea) and vestibular (semi-circular canals, utricle, and saccule) systems, is separated from the middle ear by the oval and round (labyrinthine) windows. The third ossicle, the stapes, abuts the oval window, leading into the inner ear space. The other ossicles are visible when favorable anatomical conditions are present, such as a transparent TM. It is an expected anatomical finding on otoscopy and easily visualized. The umbo is the distal portion of the malleus and connects the bony ossicles to the TM. The external auditory meatus, or the opening to the external auditory canal (EAC), extends toward and ends at the tympanic membrane (TM). Posterior to the TM is the air-filled middle ear space containing three bony ossicles: the malleus, incus, and stapes. The outside portion of the ear, the pinna, is composed primarily of ridged cartilage covered by skin. ![]() Eustachian tube dysfunction (ETD) and middle ear barotrauma (MEBT) remain the most common complication of diving and clinical hyperbaric oxygen treatment (HBO). The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.Otic Barotrauma (OBT) or ear barotrauma is a tissue injury to the ear secondary to inadequate pressure equalization between gas-filled body spaces and the external environment. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). This is particularly important when the recommended agent is a new and/or infrequently employed drug. ![]() However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. Usage and distribution for commercial purposes requires written permission. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Doctors should be aware of the severe complications underlying barotrauma such as colon perforation if care is not taken until conclusion of the colonoscopy. It is relevant to identifying “cat scratch” colon as a benign condition. Cat scratch findings disappear naturally, so no other control colonoscopy is needed. We consider and believe that the retroflexion maneuver was not the cause of the findings. The images were taken before and after a retroflexion maneuver was performed in the cecum to get the best possible image and to show the relationship with the ileocecal valve. CRP or fecal calprotectin were not demanded. Once the patient was diagnosed with barotrauma, the colonoscopy was abbreviated to avoid more serious injuries. Biopsies were not taken, although microscopic colitis might be associated with this finding. It is reasonable to think that these marks are inherent to a less complacent colon or associated with situations that can favor bleeding, so we accept that they can be observed in any case where the colon suffers a barotrauma during the colonoscopy regardless of an underlying clinical disease. Although colonoscopy by using CO 2 could be less traumatic because of the easy absorption of the gas, there is not enough evidence to suggest that it will avoid the barotrauma. In the present case the colonoscopy was performed by the process of air insufflation. It is widely accepted by most authors that the marks are caused by intramural bleeding associated with intestinal distension that is caused by insufflated air during the colonoscopy. ![]()
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