Ear Barotrauma - Pressure Gradient Across the Ear Drum

What Is Ear Barotrauma?

Ear barotrauma is a condition that causes discomfort in the ear during pressure changes. In the ear, a tube connects the middle ear to the back of the throat, known as the Eustachian tube, which is responsible for maintaining the pressure inside the ear. Anyone can have this condition when the eustachian tube is blocked. Acute ear barotrauma is common and does not cause many complications, but when the condition recurs frequently, then consult the healthcare provider. So it is important to know the difference between acute and chronic conditions so as to know when to seek medical attention.

What Are the Causes of Ear Barotrauma?

One of the main causes of ear barotrauma is eustachian tube blockage. The eustachian tube is responsible for maintaining the pressure equilibrium, so when the tube is blocked due to various reasons, the pressure cannot be made equal to the external pressure. Hence there is a pressure gradient between the external atmosphere and the internal ear.

The altitude difference is another important cause of this condition. Most people will feel ear barotrauma during the flight take off or landing due to the sudden change in altitude. The ear barotrauma while in flight is known as the airplane ear.

There are other situations too that can cause this condition, and they are:

• Scuba diving.

• Hiking.

• Driving up a mountain.

Diving Ear Barotrauma- There are high chances of having ear barotrauma as there is a drastic change in the pressure while in the water. When diving, the pressure underneath the water is much greater than on the land. The initial 14 feet of diving is the most dangerous part and can cause injury to the ear. In order to prevent this, the descent should be slow. Symptoms of ear barotrauma start immediately before or after the dive.

What Are the Risk Factors?

Any condition that can block the eustachian tube can put one at risk of developing ear barotrauma. People with allergies, colds or other active infections are more likely to develop this condition.

Compared to adults, infants and young children are more prone to this condition as their eustachian tube is shorter than adults. Also, the positioning of the tube in children increases the chance of developing ear barotrauma decreases. During the takeoff or landing of the airplane, children cry due to the effect of this condition on their ears.

How Is Ear Barotrauma Diagnosed?

Ear barotrauma usually resolves on its own once the person experiences a return to normal altitude. But in some cases, medical attention might be needed when the person experiences severe pain and bleeding from the ear. The healthcare provider will take a detailed history of the condition and might do a physical examination of the ear so as to rule out any infection. For a physical examination, the healthcare provider might use an instrument called an otoscope to see the inner structures of the ear. An otoscope is an instrument with light fitted to it used to visualize inside the ear. Due to pressure, the eardrum may appear slightly bulged inward or outward from its normal position. The healthcare provider may do insufflation in order to see if there is any fluid or blood buildup behind the eardrum. If the evaluation gives no other significant finding, then the diagnosis will be ear barotrauma.

What Is the Treatment for Ear Barotrauma?

In most cases, no intervention is needed for ear barotrauma. Some self-care tips can be done for relief, and they are:

• Yawning.

• Chewing gums.

• Breathing exercises.

• Decongestants and antihistamines if one has a cold or congestion.

In case of severe, the doctor might even advise antibiotics or steroids to treat the infection or inflammation. And severe cases can even lead to a ruptured eardrum which may take up to two months to heal. The symptoms that do not heal on their own may require surgery to prevent further damage to the eardrum.

Surgery might be the best option to treat severe or chronic cases of ear barotrauma. Severe cases of ear barotrauma may be aided with the help of ear tubes. These small cylindrical tubes are placed through the eardrum to stimulate airflow into the middle ear. Ear tubes called tympanostomy tubes are used in children to prevent infections from ear barotrauma.

The other option in surgical treatment is making a tiny slit in the eardrum to equalize the pressure. This slit will also allow the passage of any fluid up behind the ear, but the slit will heal quickly and is not a permanent solution.

What Are the Complications of Ear Barotrauma?

Ear barotrauma is a temporary condition, even though sometimes complications can arise, especially in chronic cases. If the condition is untreated, it can cause:

• Ear infections.

• Ruptured eardrum.

• Hearing loss.

• Ear pain.

• Imbalance and dizziness.

• Bleeding from the ears and nose.

How to Prevent Ear Barotrauma?

The risk of ear barotrauma can be decreased by taking decongestants or antihistamines before flying in an airplane or scuba diving. Other methods to prevent or lessen ear barotrauma include:

• Slowly descend while scuba diving.

• Swallow, yawn, or chew when you start to experience the symptoms of ear barotrauma.

• Exhale through the nose during take-off and landing of the flight.

• Avoid using earplugs while diving or flying.

Conclusion

Ear barotrauma is a condition affecting the ear due to a change in pressure which will result in pain in the ear, dizziness, and other ear-related symptoms. This condition is temporary and relieves on its own. But in some cases, the condition can result in damage to the eardrum, called the perforated eardrum, and other serious symptoms in such cases, consultation with a specialist is advised.