OTITIC BAROTRAUMA

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Ear anatomy

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Definition

Ear barotrauma is discomfort and possible damage in the ear due to pressure differences between the inside and outside of the eardrum.

Alternative Names

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

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, keeping the air pressure on both sides of the eardrum equal. If the eustachian tube is blocked, the air pressure in the middle ear is different than the pressure on the outside of the eardrum. This causes barotrauma.

Many people experience barotrauma at some time. Barotrauma commonly occurs with altitude changes, such as flying, scuba diving, or driving in the mountains. If you have a congested nose from allergies, colds, or an upper respiratory infection, you are more likely to develop barotrauma.

Blockage of the eustachian tube could also be present before birth (congenital), or it may occur because of swelling in the throat.

Symptoms

• Dizziness
• Ear discomfort or pain in one or both ears
• Hearing loss (slight)
• Sensation of fullness or stuffiness in the ears

If the condition is severe or prolonged:

• Ear pain
• Feeling of pressure in the ears (as if underwater)
• Moderate to severe hearing loss
• Nosebleed

Signs and tests

During an inspection of the ear, the doctor may see a slight outward bulge or inward pull of the eardrum. If the condition is severe, there may be blood behind the eardrum.

Severe barotrauma may be difficult to tell apart from an ear infection.

Reviewer Info: Alan Lipkin, MD, Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 10/10/2008