Summary about Disease
Otic barotrauma, also known as ear barotrauma or barotitis media, is damage to the ear caused by pressure differences between the air pressure in the middle ear and the air pressure in the environment. This commonly occurs during changes in altitude or pressure, such as flying, scuba diving, or hyperbaric oxygen therapy. It's essentially an inability of the Eustachian tube to equalize pressure.
Symptoms
Ear pain or discomfort
Feeling of fullness or pressure in the ear
Hearing loss (usually temporary)
Dizziness or vertigo
Tinnitus (ringing in the ear)
Rarely, nosebleed
In severe cases, rupture of the eardrum can occur, which can cause sharp pain, bleeding from the ear, and potential for infection.
Causes
The primary cause is the inability of the Eustachian tube to equalize pressure between the middle ear and the surrounding environment. This imbalance is typically caused by:
Changes in Altitude: Flying (especially during takeoff and landing) and ascending/descending mountains.
Scuba Diving: Rapid descent or ascent.
Hyperbaric Oxygen Therapy: Changes in pressure within the hyperbaric chamber.
Anything that obstructs the Eustachian tube: Colds, allergies, or sinus infections can make it harder for the Eustachian tube to open and close properly.
Medicine Used
The goal of medication is to relieve congestion and pain to allow the eustachian tube to open.
Decongestants: Over-the-counter or prescription decongestant nasal sprays (e.g., oxymetazoline, pseudoephedrine) can help to shrink the nasal passages and promote Eustachian tube opening. Caution: Use decongestant nasal sprays for only a few days to avoid rebound congestion.
Oral Decongestants: Oral decongestants (e.g., pseudoephedrine) can also be used, but they may have side effects such as increased heart rate or blood pressure.
Pain Relievers: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage ear pain.
Nasal Corticosteroids: In some cases, nasal corticosteroids (e.g., fluticasone) may be prescribed to reduce inflammation in the nasal passages and Eustachian tube.
Antibiotics: Only needed if a secondary bacterial infection develops due to a ruptured eardrum.
Is Communicable
No, otic barotrauma is not communicable. It is a result of physical pressure changes and not caused by an infectious agent.
Precautions
During Flights:
Chew gum or suck on hard candy during takeoff and landing to encourage swallowing and Eustachian tube opening.
Yawn frequently.
Use decongestant nasal spray about 30 minutes to an hour before takeoff or landing (use sparingly).
Avoid flying if you have a cold, sinus infection, or allergies.
Infants: Give a bottle or pacifier during takeoff and landing to encourage swallowing.
During Scuba Diving:
Descend slowly and equalize pressure frequently.
Do not dive if you have a cold, sinus infection, or allergies.
Learn and practice proper equalization techniques (Valsalva maneuver, Frenzel maneuver).
Other:
Avoid activities that cause rapid pressure changes if you have Eustachian tube dysfunction.
Manage allergies and sinus problems to reduce Eustachian tube congestion.
How long does an outbreak last?
The duration of otic barotrauma symptoms varies depending on the severity of the injury.
Mild Cases: Symptoms may resolve within a few minutes to a few hours after the pressure normalizes.
Moderate Cases: Symptoms may last for several days.
Severe Cases (eardrum rupture): Healing can take several weeks or even months, and may require medical intervention.
How is it diagnosed?
Medical History: The doctor will ask about recent activities involving pressure changes (flying, diving), as well as any relevant medical conditions like colds or allergies.
Physical Examination: The doctor will examine the ear with an otoscope to visualize the eardrum. Signs of barotrauma include:
Redness or bulging of the eardrum
Fluid behind the eardrum
Perforation (rupture) of the eardrum
Hearing Test (Audiometry): May be performed to assess hearing loss.
Tympanometry: This test measures the movement of the eardrum and can help assess Eustachian tube function and pressure in the middle ear.
Timeline of Symptoms
During Pressure Change: Ear fullness, pressure, and discomfort usually begin as the pressure changes.
Immediately After Pressure Change: Pain intensifies, and hearing may be muffled.
Within Hours: Symptoms may gradually improve as pressure equalizes, or they may persist or worsen if the Eustachian tube remains blocked.
Days/Weeks (Severe Cases): If an eardrum rupture occurs, sharp pain is followed by potential bleeding and drainage from the ear. Healing will occur over the following weeks.
Important Considerations
Prevention is Key: Taking precautions during activities involving pressure changes can significantly reduce the risk of barotrauma.
Seek Medical Attention: If symptoms are severe or persist, or if you suspect an eardrum rupture, see a doctor. Untreated barotrauma can lead to complications like infection or permanent hearing loss.
Avoid Diving with a Cold: Never dive if you have a cold, sinus infection, or allergies, as this significantly increases the risk of barotrauma.
Flying with Congestion: If you must fly with congestion, take decongestants and use nasal spray as directed.
Children are More Susceptible: Children are more prone to barotrauma because their Eustachian tubes are narrower and less efficient.
Eardrum Rupture: Keep the ear dry if you suspect an eardrum rupture to prevent infection.