• Chấn thương tai do đi máy bay

      Cơ thể của chúng ta vốn quen với áp suất không khí ngang mực nước biển (1 atmosphere) nên khi áp lực này thay đổi (tăng lên hoặc giảm đi) đều gây ảnh hưởng đến các cơ quan của cơ thể.

      Thính giác là một trong những cơ quan rất nhạy cảm với áp suất không khí và đương nhiên dễ bị tổn thương khi áp lực này tăng hoặc giảm…

      Tổn thương tai do đi máy bay (airplane ear, ear barotrauma) là những sang chấn tại màng nhĩ và mô tai giữa do sự chênh lệch áp suất trong tai giữa và khoang máy bay gây ra. Sự chênh lệch này rõ rệt nhất là khi máy bay bắt đầu cất cánh, khi máy bay lấy độ cao quá nhanh cũng như hạ độ cao khi tiếp đất.



      Cấu trúc của tai.

      Những động tác đơn giản như ngáp, nuốt, nhai kẹo cao su… có thể giúp cân bằng áp lực trong tai giữa và khoang máy bay giúp cho tai không bị tổn thương. Tuy nhiên, trong một số trường hợp nặng, vẫn cần có sự can thiệp của thầy thuốc.

      Chấn thương tai do áp lực nhìn chung không có gì đáng ngại. Các triệu chứng sẽ hết nhanh khi hiện tượng chênh áp không còn. Nhưng cũng có một số trường hợp nặng có thể dẫn đến hiện tượng ù tai liên tục hoặc mất thính lực vĩnh viễn.

      Biểu hiện của tổn thương tai do chênh áp khi bay

      Các triệu chứng của tổn thương tai xuất hiện ngay khi máy bay chạy đà để cất cánh hoặc lấy độ cao nhanh hoặc khi hạ cánh. Biểu hiện thường cả ở hai tai với các triệu chứng như ù tai, cảm giác khó chịu ở tai, giảm hoặc mất hẳn thính lực. Nếu sang chấn kéo dài, có thể thấy tai đau dữ dội, cảm giác đè chặt nặng hai tai như khi lặn sâu, hai tai nghe tiếng ong ong, chóng mặt, mất thăng bằng như say sóng, nôn mửa, thậm chí chảy máu tai, mất hẳn thính lực.

      Nguyên nhân do đâu?

      Tai giữa là một khoang kín, được ngăn cách với ống tai ngoài bằng một màng mỏng gọi là màng nhĩ. Màng nhĩ có vai trò tiếp nhận âm thanh từ môi trường bên ngoài vào tai. Bình thường, áp lực trong tai giữa được cân bằng với môi trường bên ngoài nhờ một ống nhỏ nối liền tai giữa với khoang mũi họng (eustachian tube). Khi thay đổi độ cao đột ngột, áp lực trong tai giữa không kịp cân bằng với môi trường bên ngoài nên các triệu chứng xảy ra. Khi nuốt, ngáp, nhai kẹo cao su… sẽ giúp cho ống nối tai giữa và khoang mũi họng được mở liên tục và áp suất được cân bằng.

      Một số nguyên nhân khác cũng có thể gây sang chấn tai do áp lực như lặn sâu có bình dưỡng khí, bị tát hoặc bị đánh mạnh vào tai, đứng quá gần những tiếng nổ lớn. Triệu chứng của sang chấn tai do chênh áp cũng xảy ra khi đi thang máy lên những tòa nhà cao tầng, leo núi hoặc chơi những môn thể thao như tàu lượn…

      Nguy cơ của chấn thương tai do áp lực

      Có nhiều yếu tố nguy cơ dễ gây nên chấn thương tai do áp lực như ống thông giữa tai giữa và khoang mũi họng có kích thước nhỏ ở trẻ em, người bị cảm lạnh, người đang bị viêm xoang hoặc viêm khoang mũi họng, viêm ống thông tai giữa và khoang mũi họng, viêm mũi dị ứng, viêm tai giữa, ngủ say khi máy bay cất và hạ cánh, tổn thương tai trong... Tất cả các yếu tố này đều gây hẹp tắc ống thông tai giữa và khoang mũi họng dẫn đến áp suất trong tai giữa không được cân bằng với môi trường ngoài và các triệu chứng sẽ dễ dàng xảy ra.

      Xử trí thế nào?

      Khi triệu chứng xảy ra, có thể uống các thuốc giảm đau, chống viêm, kháng dị ứng theo đơn của thầy thuốc. Người bệnh cũng được hướng dẫn một phương pháp để có thể giúp mở ống nối tai giữa và

      khoang mũi họng (còn gọi là nghiệm pháp Valsalva): người bệnh lấy tay bịt mũi, ngậm miệng lại và thở mạnh ra, đẩy khí lên phía mũi cho tới khi nghe tiếng “ục” nhẹ ở hai tai là được. Trong một số trường hợp nặng, phẫu thuật cũng được áp dụng để vá màng nhĩ bị rách nhiều, dẫn lưu dịch hoặc máu trong tai giữa... để giúp bệnh nhân phục hồi nhanh thính lực.

      Dự phòng cách gì?

      Có một số biện pháp dự phòng sang chấn tai do áp lực. Trước khi máy bay cất cánh và hạ cánh, nên nuốt nhiều, hoặc nhai kẹo cao su. Nếu triệu chứng xảy ra, có thể làm nghiệm pháp Valsalva như đã mô tả ở trên. Nếu có các bệnh viêm nhiễm đường hô hấp trên, nhất thiết phải được điều trị bằng các thuốc chống viêm, kháng dị ứng, các thuốc chống tắc nghẽn... để mũi họng được thông thoáng. Nên uống đủ nước, không uống rượu bia khi đi máy bay. Không nên ngủ khi máy bay cất cánh, hạ cánh. Cũng có thể sử dụng nút bông gòn để nút tai khi cần.

      TS. Bs. Vũ Đức Định
      Nguồn: suckhoedoisong.vn
      Comments 17 Comments
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