Maneuver | Description | Comment |
Simple techniques | Yawn, swallow, jaw thrust, head tilt | Useful in patients with widely patent Eustachian tubes, but usually ineffective with marginally patent Eustachian tubes |
Frenzel maneuver | Diver pinches the nostrils, closes the glottis, and makes a "k" or "guh" sound to compress air in the back of the throat | Can be performed at any point in the respiratory cycle and can be quickly repeated. |
Valsalva maneuver | Diver pinches the nostrils, tightens cheek muscle and exhales forcefully | Prolonged efforts can reduce systemic venous return and cause hypotension |
Toynbee maneuver | Diver pinches the nostrils while swallowing | Limited effectiveness during rapid descent |
Beance tubaire voluntaire maneuver | Diver contracts the muscles of the soft palate while using the muscles of the upper throat to open the Eustachian tubes | Difficult to teach and not easily mastered |
Roydhouse maneuver | Diver contracts the muscles of the soft palate while tensing the tongue to open the Eustachian tubes | Difficult to teach and not easily mastered; concomitant jaw thrust may be helpful |
Edmonds technique | Combination of pressurization from the Frenzel or Valsalva maneuver with a jaw thrust or head tilt | |
Lowry technique | Diver pinches the nostrils, builds up pressure with a Frenzel or Valsalva maneuver, and simultaneously swallows | Requires coordination and practice but is very effective |
Twitch maneuver | Diver builds up pressure with a Frenzel or Valsalva maneuver, then suddenly twitches the head sideways | Throat muscle tension increases effectiveness of the technique |
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