Ear barotrauma

Alternative names

Barotitis media; Barotrauma; Ear popping; Pressure-related ear pain; Eustachian tube dysfunction

Definition

A condition of discomfort in the ear caused by pressure differences between the inside and the outside of the eardrum.

Causes, incidence, and risk factors

The air pressure in the middle ear is usually the same as the air pressure outside of the body. The eustachian tube is a connection between the middle ear and the back of the nose and upper throat. Swallowing or yawning opens the eustachian tube and allows air to flow into or out of the middle ear, equalizing the air pressure on both sides of the eardrum. If the eustachian tube is blocked, the air pressure in the middle ear is different than the pressure on the outside of the eardrum, causing barotrauma.

Many people experience barotrauma at some time. Barotrauma commonly occurs with altitude changes, such as with flying, scuba diving, or driving in the mountains. If you have a congested nose from allergies, colds, or upper respiratory infection, barotrauma is more likely. Blockage of the eustachian tube could also be congenital or may occur because of swelling in the throat.

Symptoms

• ear discomfort or pain in one or both ears
  
• hearing loss, slight
  
• sensation of fullness or stuffiness in the ears
  
• dizziness
  

If severe or prolonged:

• hearing loss, moderate to severe
  
• feeling of pressure in the ears (as if underwater)
  
• nosebleed
  
• ear pain
  

Signs and tests
During an inspection of the ear, the doctor may see a slight outward bulge or inward retraction of the eardrum. If the condition is severe, there may be blood behind the eardrum. Severe barotrauma may be difficult to distinguish from ear infection.

Treatment

To relieve ear pain or discomfort, first attempt to open the eustachian tube and relieve the pressure. Suck on candy, chew gum, or yawn. Or inhale, then gently exhale while holding the nostrils closed and the mouth shut.

When flying, do not sleep during the descent. Frequently open the eustachian tube by these measures. Allow infants and children to nurse or sip a drink during descent.

Divers should descend and ascend slowly. Diving is dangerous during respiratory infections or allergies because barotrauma may be severe.