Ultrasound for diagnosing inner ear decompression sickness

A 26-year-old male presented at our hospital complaining of vertigo after scuba diving. He had directional nystagmus and was hard of hearing in his right ear. An ultrasound study revealed a snowstorm pattern in the inferior vena cava, corresponding to grade III by Spencer’s classification without persistent foramen ovale. He was diagnosed with decompression sickness and hyperventilation and transferred to the medical facility for hyperbaric oxygen recompression therapy. The presence of gas bubbles in the vascular system is often considered a sign of decompression sickness, and a positive relationship has been reported between the amount of bubbles detected on ultrasonography and the incidence of decompression sickness. Ultrasound may therefore be useful for diagnosing decompression sickness.