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 |