RESUMEN
PURPOSE: To investigate the potential correlation between prolonged exposure to microgravity on the International Space Station and increased intracranial fluid pressure, which is considered a risk factor for the astronauts' vision, and to explore the feasibility of using distortion product otoacoustic emissions as a non-invasive in-flight monitor for intracranial pressure changes. METHODS: Distortion product otoacoustic emission phase measurements were taken from both ears of five astronauts pre-flight, in-flight, and post-flight. These measurements served as indirect indicators of intracranial pressure changes, given their high sensitivity to middle ear transmission alterations. The baseline pre-flight ground measurements were taken in the seated upright position. RESULTS: In-flight measurements revealed a significant systematic increase in otoacoustic phase, indicating elevated intracranial pressure during spaceflight compared to seated upright pre-flight ground baseline. Noteworthy, in two astronauts, strong agreement was also observed between the time course of the phase changes measured in the two ears during and after the mission. Reproducibility and stability of the probe placement in the ear canal were recognized as a critical issue. CONCLUSIONS: The study suggests that distortion product otoacoustic emissions hold promise as a non-invasive tool for monitoring intracranial pressure changes in astronauts during space missions. Pre-flight measurements in different body postures and probe fitting strategies based on the individual ear morphology are needed to validate and refine this approach.