Ear Barotrauma

Pain and pressure injury from unequal air pressure

Overview

Ear barotrauma is injury caused by a difference in pressure between the middle ear and the surrounding environment. It occurs when the Eustachian tube cannot open to equalize pressure quickly enough during rapid changes in altitude or depth, most often during aircraft descent or diving. As outside pressure rises, the eardrum is pushed inward, causing pain, muffled hearing, and fullness, and in more severe cases bleeding into the middle ear or perforation of the eardrum. Colds, allergies, and other causes of nasal congestion make it more likely because they impair Eustachian tube function. Equalization techniques, including swallowing, yawning, and the Valsalva manoeuvre, are widely described in aviation and diving training. Most middle ear barotrauma resolves on its own, and many perforations close without intervention. Inner ear barotrauma, which can cause sensorineural hearing loss and vertigo, is less common and more serious.