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Barotrauma: A High-Flying Condition

Barotrauma is an ear injury or discomfort you may experience when flying, scuba diving or driving in the mountains.

It is caused when the air pressure in your ears is different from the air pressure surrounding you. You feel the pain or discomfort when the pressure change is dramatic.

Although you may be most familiar with barotrauma in the ear, barotraumas also can occur in other areas of the body including the ear, face and lungs.

Effects in the ear

Barotrauma can affect all three parts of the ear: the outer, visible part; the middle ear, which is separated from the outer ear by the eardrum, and contains the small bones that transfer sound to the auditory nerve; and the inner ear, which contains the auditory nerve that transfers sound to the brain. The middle ear is the most commonly affected by barotrauma.

Air pressure in the middle ear is controlled by the eustachian tube. This narrow tube connects the middle ear to the back of the nose and upper throat. It opens and closes to allow air to flow in and out of the middle ear and keep the pressure on both sides of the eardrum equal.

Under normal circumstances, your body is able to equalize differences in air pressure that occur between the middle ear and the environment, according to the American Academy of Otolaryngology-Head and Neck Surgery. Problems occur when the eustachian tube is blocked by a cold, and air pressure on either side of the eardrum becomes uneven.

Barotrauma can cause pain; slight, temporary hearing loss; and, in extreme cases, rupture of the eardrum. Taking some precautionary measures can help you avoid or reduce barotrauma.

Differences in air pressure can occur during air travel, when driving over mountain passes and on impact with water when water skiing or scuba diving. People who are suffering from allergies or colds or who have experienced difficulties in the past with ear or sinus pressure during altitude change are at risk for barotrauma.

Pressure relief

During take-off and descent, it can be helpful to swallow frequently, chew gum or suck on candy. Swallowing and yawning move the muscle that opens the Eustachian tube Another technique is to gently blow air out of the nose while the mouth is closed and nose is slightly pinched.

For immediate relief of pain associated with air pressure, a nasal decongestant spray may help. It should be used only according to the directions and not for more than three days in a row. Your symptoms can worsen if you use it for more than three days. If you have high blood pressure, heart disease or any heart rhythm problems, talk to your doctor before using decongestants.

Staying well hydrated is also important to help keep the nose and throat clear. You should drink non-alcoholic liquids every hour. When traveling by plane, carry a water bottle to make sure fluids are easily at hand.

If you have a cold, sinus infection, or allergy symptoms, talk with your health care provider about air travel.

Online Medical Reviewer: Byrd, Sylvia RN, MBA
Online Medical Reviewer: Chang, Alice MD
Online Medical Reviewer: Daphne Pierce-Smith, RN, MSN, FNP, CCRC
Online Medical Reviewer: Godsey, Cynthia M.S., M.S.N., APRN
Online Medical Reviewer: Lambert, J.G. M.D.
Online Medical Reviewer: Lee Jenkins
Date Last Reviewed: 12/10/2009
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