Barotrauma(Ear Barotrauma, Barotitis Media, Ear Popping, Ear Pressure, Airplane Ear; Sinus Barotrauma, Aerosinusitis, Barosinusitis; Pulmonary Barotrauma, Pulmonary Overpressurization Syndrome)Pronounced: ba-roh-TRAW-mah
by
Diane A. Safer, PhD DefinitionBarotrauma is the pain or discomfort that is felt with a difference in air or water pressure between the outside environment and the inside of the body. Any part of the body that contains air can be sensitive to these pressures:
CausesNormally air moves easily between outside and inside of the ear, sinuses, and lungs, helping to maintain a balance of pressure. Imbalances may be created with:
The imbalance of pressure causes the air inside your body to shrink or swell. This is what can cause pain and damage. Risk FactorsActivities that can expose someone to significant pressure changes include:
The inner ear is connected to outside air through tubes to keep inner and outer pressure balanced. Blockages and congestion in these tubes increase the risk of ear barotrauma because the inside pressure is not allowed to change to match the outside pressure. These tubes may be blocked or limited by:
Similarly, blockages in the sinuses will block the flow of air from outside to inside the body. Sinuses may be impaired by:
Pulmonary barotrauma may be more likely in those with damage from previous or current lung conditions. Other factors that may affect the ability for air spaces in the body to work properly include: SymptomsSymptoms will depend on what areas are affected. Ear barotrauma may cause:
Complications include long-term or permanent hearing loss, ear infection, or a perforated eardrum. Sinus barotrauma may cause:
Pulmonary barotrauma may cause:
Potential complications can include pneumothorax and stroke. DiagnosisYour doctor will ask about your symptoms and medical history. A physical exam will be done to look for irritation or tissue damage. Barotrauma may be suspected based on your recent activities, such as air travel or scuba diving. Ear structures will be visually examined Suspected pulmonary barotrauma may be evaluated with:
TreatmentPulmonary barotrauma is serious and needs immediate medical attention. Treatment will depend on the specific lung problem that is present. The following measures can also prevent barotrauma. Treatment options include the following: Measures to Relieve PressurePressure can be relieved with self-care and medications. Self-careTo relieve the pressure in the eustachian tube, you can:
MedicationsIt is important to relieve nasal congestion and open your eustachian tube. Medications to relieve ear and sinus pressure include:
Pain relievers can be used if ear or sinus pressure is causing pain. Antibiotics may be used if a bacterial infection is present or possible. Emergency CareEmergency medical care may include: SurgerySurgery may be necessary to relieve the pressure if your eustachian tube does not open with other treatments. Your doctor will make a small cut in your eardrum to equalize the air pressure. Any fluid blocking the tube may also be removed. Oxygen TreatmentOxygen should be given immediately for pulmonary barotrauma. The oxygen can be given through a mask over the face or by a tube under the nose. PreventionTo help reduce your chances of barotrauma during: Air Travel
To help your baby through pressure changes, give your baby a pacifier or bottle during landing and take off. Scuba Diving
RESOURCES:American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org Divers Alert Network https://www.diversalertnetwork.org CANADIAN RESOURCES:Canadian Society of Otolaryngology—Head and Neck Surgery http://www.entcanada.org Health Canada https://www.canada.ca References:Barotrauma. American Hearing Research Foundation website. Available at: ...(Click grey area to select URL) Updated October 2012. Accessed December 21, 2017. Barotrauma. Merck Manual Professional Version website. Available at: ...(Click grey area to select URL) Updated July 2017. Accessed December 21, 2017. Brandt MT. Oral and maxillofacial aspects of diving medicine.
Military Medicine.
2004;169(2):137-141. Diving precautions and prevention of diving injuries. Merck Manual Professional Version website. Available at: ...(Click grey area to select URL) Updated July 2017. Accessed December 21, 2017. Ears and altitude. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: ...(Click grey area to select URL) Accessed December 21, 2017. Newton HB. Neurologic complications of scuba diving.
Am Fam Physician. 2001;63(11):2211-2218. Last reviewed November 2018 by
EBSCO Medical Review Board
Marcin Chwistek, MD Last Updated: 12/20/2014 |
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