Definition: Middle ear trauma due to rapid & marked decrease in middle ear pressure.
Gas must move freely between the middle ear and nasopharynx in order to maintain equal pressure on both sides of the tympanic membrane.
- During ascent: atmospheric pressure decreases so middle ear pressure becomes relatively positive this is corrected by passive outflow of air from middle ear along Eustachian tube (E.T).
- During diving & airplane descent: atmospheric pressure increases so middle ear pressure becomes relatively negative this can be corrected only by active opening of E.T (by swallow) to allow air inflow to middle ear.
- So otitic barotrauma occurs when E.T fails to open, this results in retraction, rupture, and effusion.
Symptoms and signs of Otitic barotrauma:
- Earache, discomfort & fullness in ear.
- Retracted congested tympanic membrane (T.M).
- Middle ear effusion (may be haemotympanum).
- Tympanic membrane rupture.
- Tuning fork: Conductive deafness (C.D).
Treatment of Otitic barotrauma
1- Avoid flying with common cold.
2- Avoid sleep during descent.
3- Chewing gums.
4- Nasal & oral decongestants.
In retraction: valsalva’s maneuver.
In severe retraction or effusion: myringotomy
In rupture: as traumatic perforation