In medicine, the Valsalva maneuver is performed by forcibly exhaling against closed lips and pinched nose, forcing air into the middle ear if the Eustachian tube is open. This maneuver with slight modifications can be used as a test of cardiac function and autonomic nervous control of the heart or to ‘clear’ the ears (equalize pressure) when ambient pressure changes, as in diving or aviation.
The technique is named for Antonio Maria Valsalva, the 17th Century physician and anatomist from Bologna, whose principal scientific interest was the human ear. He described the Eustachian tube and the maneuver to test its patency.
The normal physiological response consists of 4 phases, which are marked on the figure at right:
Deviation from this response pattern signifies either abnormal heart function or abnormal autonomic nervous control of the heart.
When rapid ambient pressure increase occurs as in diving or aircraft descent, this pressure tends to hold the Eustachian tubes closed, preventing pressure equalization across the ear drum, with painful results. To avoid this painful situation, divers, caisson workers and pilots attempt to open the Eustachian tubes by swallowing, which tends to open the tubes, allowing the ear to equalize itself.
If this fails, then the Valsalva maneuver may be used. It should be noted this maneuver, when used as a tool to equalize middle ear pressure, carries with it the risk of auditory damage from over pressurization of the middle ear. It is safer, if time permits, to attempt to open the Eustachian tubes by swallowing a few times, or yawning.
Note that in a clinical setting the Valsalva maneuver will be done either against a closed glottis, or against an external pressure measuring device, in each case either eliminating or minimizing the pressure on the Eustachian tubes. Straining, blowing against resistance as in blowing up balloons has a Valsalva effect and the fall in blood pressure can result in dizziness and even fainting.
The Valsalva maneuver may be used to arrest episodes of supraventricular tachycardia. The maneuver can sometimes also be used to diagnose heart rhythm abnormalities, especially when used in conjunction with echocardiogram.
----- Original Message -----From: [log in to unmask] href="mailto:[log in to unmask]">Nicola SpencerTo: [log in to unmask] href="mailto:[log in to unmask]">[log in to unmask]Sent: Tuesday, June 05, 2007 9:45 AMSubject: [OCC-HEALTH] Valsalva ear testsHas anyone ever carried out valsalva ear tests and if so can they offer
any advice?
This is for lifeguards at a Leisure centre who are required to dive 6
metres to retreive a manikin.