Barotrauma

Damage to the structures of the EAR resulting from the ear’s inability to equalize pressure with abrupt and extreme changes in atmospheric pressure. Such changes most often occur in situations of sudden altitude change such as air travel or diving, though also may result from a sharp blow to the ear that forces a blast of air into the auditory canal. Any of the three parts of the ear—outer, middle, and inner—can experience injury from barotrauma.

 

• Outer ear barotrauma typically takes the form of small, painful blisters and hemorrhages along the walls of the auditory canal.
• Middle ear barotrauma commonly includes a ruptured TYMPANIC MEMBRANE (eardrum). The pressure within the middle ear can become intense before the tympanic membrane gives way, causing much PAIN. With rupture the pressure immediately equalizes, though hearing ability temporarily diminishes.
• Inner ear barotrauma causes sudden and usually significant VERTIGO (extreme dizziness and balance disturbances) and HEARING LOSS that can be permanent.

Most outer and middle ear barotrauma heals on its own. Many ruptured eardrums heal naturally, though large or irregular tears require surgical repair (TYMPANOPLASTY). Inner ear barotrauma may require surgery to repair damaged structures and may result in permanent functional loss if the damage is extensive.

Preventive measures to reduce the likelihood of barotrauma include chewing gum, frequent swallowing, and yawning during activities that involve changes in barometric pressure such as descending during air travel. Some people benefit from nasal decongestant sprays that clear the nasal passages and eustachian tubes. Recreational divers are at greatest risk for inner ear barotrauma; pressure changes are most drastic nearer the surface than deep in the water.