Ear barotrauma refers to ear pain caused by a change in pressure around the ear. It can cause discomfort or pain as well as difficulty hearing.
Ear barotrauma usually clears up by itself, but some people may need to talk to a doctor, and in very severe cases, have corrective surgery.
It is important that people understand what ear barotrauma is so that they can seek medical attention if necessary. Read on for an overview of the causes, symptoms, and treatment of this condition.
Ear barotrauma is a condition that causes a person to feel pain or discomfort in the middle of their ear due to pressure changes in the surrounding air or water.
Scuba diving can often cause ear barotrauma, and it is also common during an airplane take-off or landing. Certain infections and blockages can cause ear barotrauma too.
The condition can be acute or chronic. Acute cases are common and generally harmless. However, a person with chronic ear barotrauma will experience prolonged symptoms, which may lead to further complications.
A blockage of the eustachian tube, which connects the ear and mouth, is a common cause of ear barotrauma.
The eustachian tube is responsible for maintaining balance when there are external changes in pressure. If a blockage occurs in the tube, the pressure differences inside and outside the middle ear can cause the symptoms of ear barotrauma.
The change in altitude when taking off or landing in an airplane can also cause ear barotrauma. The rapid ascent and descent of the plane combined with the pressurized cabins can cause an imbalance in pressure between the middle ear and outer ear. Altitude changes that occur when going quickly up or down a mountain can have similar effects.
It is also common for people to experience ear barotrauma while scuba diving, as changes in water pressure affect the tympanic cavity in the ear. When diving, it is crucial to descend slowly to prevent rapid changes in pressure causing injury to the ear.
The symptoms of ear barotrauma differ according to how severe and prolonged it is. Initially, a person may only feel an uncomfortable pressure inside the ear, but sometimes the condition can progress and worsen.
When air pressure changes are responsible for ear barotrauma, it often goes away as soon as the air pressure outside has normalized, and should not cause any further symptoms.
However, people may experience additional symptoms when ear barotrauma results from illness or a blockage in the middle ear.
Doctors classify ear barotrauma as either acute or chronic. Acute cases are quite common and are generally harmless. Chronic cases occur for an extended period and have the potential to cause further complications.
In mild cases, or when ear barotrauma first starts, a person may experience:
- difficulty hearing or mild hearing loss
- a feeling of fullness in the ear
- overall discomfort in the ear
In moderate to severe cases, or if ear barotrauma persists without treatment, a person may experience additional or worsening symptoms. These may include:
- injury to the eardrum
- fluid leakage or bleeding from the ear
- increased pain in the ear
- pressure sensation in the ear, similar to how it feels being underwater
- moderate to severe hearing loss
People with these symptoms may need to seek treatment to get symptom relief.
Mild cases of ear barotrauma cause symptoms that typically only last for a few minutes before clearing on their own.
In severe cases, a person may need treatment to resolve an underlying cause. The recovery time will depend on the severity of the underlying cause.
Ear barotrauma can sometimes lead to a ruptured eardrum, also called tympanic membrane perforation. If this happens, it may take several months for the ear to heal completely. A ruptured eardrum often heals spontaneously, but, if this is not the case, it is possible to repair the eardrum with surgery.
In most cases, the symptoms will clear up before a person can see their doctor. However, if the pain is severe or constantly recurring, or there is fluid leakage or bleeding from the ear, a person should see their doctor.
The doctor will ask when the symptoms occurred to see if they relate to air or water pressure changes. They will then check for ear infections and examine the eardrum and the inside of the external ear canal to look for signs of ear barotrauma.
If the eardrum appears to be pushed in or out, this can indicate ear barotrauma. The doctor can check this by applying a small burst of air into the ear to look for fluid buildup or blood behind the eardrum. In some cases, there is no physical evidence of ear barotrauma.
Following the examination, the doctor will discuss the most appropriate treatment options and next steps.
Most cases of ear barotrauma will resolve after a short period without the need for medical intervention.
However, it should be possible to relieve the symptoms of mild ear barotrauma by using certain techniques to help open the eustachian tube. This allows air to enter or leave the middle ear to equalize the pressure. These techniques include:
- Chewing gum, sucking on a lozenge, swallowing, or yawning. Using the mouth helps to open up the eustachian tube.
- Taking an over-the-counter (OTC) nasal decongestant, antihistamine, or both. If a person has upper respiratory congestion or an allergy, this may help the eustachian tube to stay open.
- Stopping a diving descent at the first sign of ear discomfort to allow time for equalizing.
People should avoid putting drops in the ear.
It is essential to keep the ear clean and away from contamination to prevent any infection while it is healing. If an infection is present, a doctor may prescribe antibiotic therapy.
In cases of chronic or severe ear barotrauma, a doctor may decide that surgery is necessary. Using a particular surgical procedure, it is possible to implant small cylinders called ear tubes into the ear. These can relieve middle ear problems.
The use of ear tube placement surgery is common in children who have hearing loss due to recurrent infections or ongoing fluid collection in the middle ear. However, surgeons rarely use this procedure to treat ear barotrauma.
A person can reduce their risk of experiencing ear barotrauma by taking a decongestant, an antihistamine, or both before activities where pressure changes are common. These include scuba diving, hiking, and flying in an airplane.
They can also preempt the symptoms and use the same techniques that can relieve early symptoms. These include:
- descending slowly on dives
- exhaling through the nose while ascending
- chewing, yawning, sucking on a lozenge, or swallowing
- staying awake during take-off and landing in an airplane
Most cases of ear barotrauma are benign and will resolve without medical treatment. A person should consider seeking medical attention if additional symptoms accompany the sensation, it lasts for a long time, or it occurs frequently.
Following treatment, a person should not experience further complications and can expect a full recovery.