What Is Barotrauma?


Barotrauma is tissue damage due to differences in pressure in the body with the air pressure around it. The most common Barotrauma is Ear Barotrauma. The condition occurs when the eardrum becomes tense and attracted due to differences in pressure inside and outside the ear. Under normal circumstances, the air pressure on both sides of the eardrum should be the same, so that it can function properly. Air pressure regulator in the ear is played by an eustachian tube that is behind the eardrum. When the tube is blocked, there is a difference of pressure on the inside and outside of the ear, so that there is barotrauma. Barotauma is characterized by a distressed eardrum or stretched so that the ears are painful and clogged so that hearing will be reduced.

Barotrauma ear is also common when traveling by plane or known also by the name of media barotitis or aerotitis. Changing the altitude of the aircraft quickly can trigger media barotitis. The same thing can happen under water while diving. The deeper the dive, the higher the air pressure will make the ear feel uncomfortable. The groups most at risk of ear barotrauma are children and young adults, because their eustachian tubes are shorter and have slightly different shapes than adults. Nevertheless, most people with barotrauma can fully recover.


Symptoms of Barotrauma
Common symptoms felt by ear barotrauma patients are dizziness, ears feel uncomfortable and full, and hearing loss or difficult to hear If left unchecked, symptoms increase intense, including:
  • The ears are painful.
  • Injury to the eardrum .
  • Nosebleeds (fractures on the nose).
  • The ears are buzzing (tinnitus).
  • Bleeding in the ears.
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Causes of Barotrauma
In general, barotrauma occurs due to altitude changes, such as when boarding a plane, climbing a hill, driving on a mountain, diving, near the blast site, or in a hyperbaric oxygen chamber. Under these conditions, the air pressure outside the ear will be much higher that will suppress the eardrum. This inward-pressed ear drum is not capable of performing a proper voice delivery function, so your hearing will be interrupted. If this pressure difference is not immediately stabilized, there will be pain in the ear on the ear.

In addition, the obstruction of the eustachian tube is the second most common cause of barotrauma. Eustachian tube blockage is common in people who suffer from allergies, active infections, and colds. The risk factor for ear barotrauma in children is generally due to their smaller eustachian tube size compared to adults so it is easily inhibited.


Diagnosis of Barotrauma
Diagnosis of ear barotrauma is determined through the history of symptoms and ear examination using a device with a lamp called the otoscope to see the condition of the eardrum. In the barotrauma, the eardrum is pushed more or less inward. The doctor will also see whether or not there is a pile of fluid or blood behind the eardrum.

As for the conditions that are severe enough where patients experience vertigo, auditory tests (audiometry) needs to be done to detect how well the patient's hearing ability and find out if the source of the hearing problem is in the inner ear.


Treatment of Barotrauma
Treatment of the ear barotrauma can be started with several self-care steps to ease the effects of air pressure on the ear, including:
  • Yawning. This volatile activity will open the eustachian tube, so the symptoms of barotrauma can be reduced.
  • Chew candy as the plane begins to land for air to flow into the eustachian tube. For babies, give them water or milk when the plane is landing so they are encouraged to swallow.
  • Try not to sleep when the plane will land in order to swallow to ensure air into the middle ear.
  • Perform vasalva maneuver. Inhale and release the air slowly by closing the mouth and nose. Repeat this movement every few minutes until the plane lands completely.
  • Avoid using earplugs when the plane takes off or landing.
In addition, the administration of nonsteroidal anti-inflammatory drugs such as ibuprofen , naxproxen , or painkillers (analgesics) can also relieve ear discomfort.

Meanwhile, to prevent clogging of the eustachian tubes, doctors may administer decongestant medications and oral antihistamines , decongestant sprays, and ear drops for children to relieve pain during a plane ride.

In the case of chronic barotrauma, then one option that can be done is surgery. This action is to stimulate airflow to the middle ear by installing a small cylinder inside the eardrum. This cylinder placement is carried out for 6 to 12 months.


Barotrauma Complications
Barotrauma is usually not serious and can be treated with care independently. However, if the condition is serious and lasts for a long time, then the possibility of the structure of the middle and inner ear damage. Complications that can occur, among them are permanent loss of hearing and chronic tinnitus that lasts continuously.

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