Otitic barotrauma

What it is

Otitic barotrauma is a non suppurative condition due to failure of the eustachian tube to maintain middle ear pressure. Ear barotrauma is caused by rapid changes in pressure.

The figure shows what happens: with the eustachian tube open the air pressure on the two sides of the eardrum is equal; with the eustachian tube blocked the pressure is unequal and the eardrum bulges inward.

What brings it on

The most common cause is flying, that is rapid descent during air flight. The others are underwater diving, decompression, hyperbaric oxygen chambers and blast injuries. Diving is the one the cases use: a 27-year-old male with sudden ear pain, tinnitus and nausea and a history of diving ear injury is otitic barotrauma.

How it presents

• Blockage of the ears, with popping, and a feeling of pressure in the ear.
• Severe otalgia with headache, and it may be accompanied by nausea, vomiting, vertigo and tinnitus.
• Conductive hearing loss, which is acute and transient.
• Traumatic rupture of the tympanic membrane, which mostly heals spontaneously without any ear dysfunction.