Barotrauma: causes, treatment, and recovery time

Barotrauma

Barotrauma refers to injuries caused by increased air or water pressure, such as during airplane flights or scuba diving. Barotrauma of the ear is common. Generalized barotraumas, also called decompression sickness, affects the entire body.

Your middle ear includes the eardrum and the space behind it. The only connection between your middle ear and the "outside world" is a thin canal called the Eustachian tube. This connects your ear with the back of your mouth. When you swallow, you may notice a small click in your ears. This is a bubble of air being moved through the Eustachian tube. These bubbles are constantly moving into the middle ear, where they balance the ear's inner pressure. Ear barotrauma can occur when these tubes become blocked or partially blocked.

On an airplane, barotrauma to the ear – also called aero-otitis or barotitis – can happen as the plane descends for landing. Barotrauma of the ear also can happen when scuba divers descend. The pressure change can create a vacuum in the middle ear that pulls the eardrum inward. This can cause pain and can muffle sounds. Your ear will feel stuffed and you may feel as if you need to "pop" it.

Barotrauma is the most common medical problem reported by air travelers. It is much more likely to happen to people who have colds, allergies or infections when they are flying. It is common in children because their Eustachian tubes are narrower than those of adults and become blocked more easily.

Symptoms

Common symptoms of ear barotrauma include:

• Ear pain
• A sensation that the ears are stuffed
• A need to "pop" your ears by swallowing, yawning or chewing gum

More severe signs include:

• Extreme pain in the ear
• Dizziness (vertigo)
• Bleeding or fluid coming from the ear, which can mean you have a ruptured eardrum
• Hearing loss

Diagnosis

You can diagnose a mild case of ear barotrauma yourself, and you do not need to see a doctor. If you are uncertain about your symptoms or if your symptoms last a long time, a doctor can examine your middle ear with a lighted magnifying tool called an otoscope to see if the eardrum is pulled inward. Clear fluid behind the eardrum sometimes can be difficult to see. If a collection of fluid is not visible, your doctor may squeeze a puff of air into your ear canal. If the eardrum does not move well, you probably have fluid behind the eardrum. A perforated eardrum can be diagnosed by looking at the ear with an otoscope.

Prevention         

To prevent barotrauma, your Eustachian tubes must stay open. If you have a cold, ear infection or allergy, you may want to reschedule airplane travel until you are better. If you or your child must fly with a cold, infection or allergy, take a decongestant about one hour before your flight. Continue taking the medication during the flight according to the package directions. You also can use a decongestant nasal spray. Antihistamines may also be helpful. Ear plugs have been developed that can slow down the pressure change that affects the ear. These might give your ears some additional time to adjust to pressure changes. These plugs can be used for air travel but they are not useful for diving.

During a flight, make sure you are awake for the landing so you can "pop" your ears if necessary. (If you ask, a flight attendant will wake you.) Infants should be kept awake during a flight's descent and can be given a bottle or pacifier to suck on to help keep their Eustachian tubes open. Keep the child upright as the plane descends.

Treatment

If you experience the symptoms of barotrauma during a flight, there are several things you can do:

• Chew gum or suck on hard candy.
• If you don't have gum or candy, yawn and swallow frequently.
• If these methods don't work, pinch your nose closed, inhale through your mouth, and then try to push the air out through your nose while keeping it pinched shut. Don't push hard, and stop as soon as one ear pops. If you blow too hard, you can tear your eardrums, so do it carefully.

Most cases of persistent barotrauma of the ear can be treated with decongestants. In unusually persistent cases, an ear, nose and throat doctor may have to make a small incision in the eardrum to equalize the pressure and drain the fluid. If you have a ruptured eardrum, you need to keep water out of your ear to prevent infection. A perforation of the eardrum that has not healed after two months may need to be repaired surgically.

When To Call a Professional         

If you experience dizziness that includes a feeling of spinning or falling (vertigo) and your symptoms occur right after flying or diving, you need to be evaluated by a doctor immediately because there is a small chance you may need emergency ear surgery. If you have severe pain, bleeding or drainage of fluid from your ears, see a doctor within several days because you may have a ruptured eardrum. If you have mild ear pain or hearing difficulty that continues after flying or diving, you should see a doctor for help if your symptoms are slow to go away.

Source : https://www.health.harvard.edu/a_to_z/barotrauma-a-to-z