What is Ear Barotrauma?

The term ear barotrauma refers to discomfort, pain and damage caused by pressure differences between the inner and outer ear. This is a common type of ear trauma that normally does not cause serious or permanent damage to the ear. Ear barotrauma commonly causes feelings of discomfort and pressure in the ears, and it can cause temporary hearing loss. Severe barotrauma of the ear can cause pain, intense feelings of pressure, nosebleed, burst ear drum or severe hearing loss.

The ear has three main sections: the outer, middle and inner ears. The junction of the outer ear and the middle ear is separated by a structure called the ear drum, which is essential for hearing. The middle ear and the nose and upper throat are connected via a tube called the eustachian tube, which helps to maintain equal pressure in the outer and inner ear. If this tube becomes blocked, the pressure equilibrium cannot be maintained, leading to a pressure difference between the outer and inner ear. Ear barotrauma is caused by the difference in pressure.

Ear barotrauma most often occurs in situations where someone moves to or from a higher-pressure environment. For most people, these situations occur when they fly in an airplane, hike or drive up a mountain or go free-diving or scuba diving. The risk of ear damage occurring is heightened in someone who has a congested nose as a result of a cold or upper respiratory tract infection or allergies. This is because the congestion makes it more likely that the eustachian tubes will become blocked.

In general, the barotrauma caused while flying in an airplane is harmless. The pressure differential that is created is small, and the discomfort it causes can be alleviated by chewing gum, sucking candy, yawning or swallowing during ascent or descent of the plane. In most cases, the symptoms will clear up completely shortly after ascent or descent is completed, but blocked eustachian tubes might increase symptom duration.

The risk of severe ear damage as a result of ear barotrauma is highest when descending or ascending in water while diving. Descending just 10 meters (33 feet) under water doubles the ambient pressure on a diver. If the pressure equilibrium can not be maintained, significant damage, such as a burst ear drum, can result.

This risk of this type of barotrauma can be reduced by descending and ascending slowly during a dive or by using a technique called the Valsalva maneuver. In this technique, the individual exhales gently while holding the nose and mouth shut. In addition, someone with allergy symptoms or a respiratory infection should avoid diving, because of the increased risk of blocked eustachian tubes.