Barotrauma

( Ear Barotrauma , Barotitis Media, Ear Popping, Ear Pressure, Airplane Ear; Sinus Barotrauma , Aerosinusitis, Barosinusitis; Pulmonary Barotrauma , Pulmonary Overpressurization Syndrome)

Definition

Barotrauma is the pain or discomfort that is felt with a difference in air or water pressure between the outside environment and the inside of the body.Any part of the body that contains air can be sensitive to these pressures:
  • Ear (most common)—affecting structures in the middle ear
  • Sinus—air-filled facial sinuses surround the bones in the skull
  • Pulmonary (most critical)—lungs
The Ear
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Causes

Normally air moves easily between outside and inside of the ear, sinuses, and lungs, helping to maintain a balance of pressure. Imbalances may be created with:
  • Sudden or severe changes in surrounding pressure
  • Blockages in the body's air cavities
The imbalance of pressure causes the air inside your body to shrink or swell. This is what can cause pain and damage.

Risk Factors

Activities that can expose someone to significant pressure changes include:
  • Airplane travel
  • Scuba diving, particularly:
    • Ascending (going up to the surface) without exhaling freely
    • Swimming quickly to the surface when diving
    • Holding your breath when ascending
    • Underwater diving for an increased period of time
    • Repeated dives within 24 hours
    • Flying in an airplane after diving
    • Having air pockets in equipment (such as masks and dry suits)
  • Mechanical ventilation —use of a machine to move air into and out of the lungs (associated with pulmonary trauma)
  • Exposure to shock waves from an explosion
The inner ear is connected to outside air through tubes to keep inner and outer pressure balanced. Blockages and congestion in these tubes increase the risk of ear barotrauma because the inside pressure is not allowed to change to match the outside pressure. These tubes may be blocked or limited by:
  • Congestion from allergies or colds
  • Middle ear infections—more common in younger children
  • Defects of eustachian tube (small tube that runs from the middle ear to the back of the nose and upper throat and helps stabilize internal and external pressures)
  • Damaged or blockage of eustachian tube—resulting from scarring or a tumor
  • Cleft palate or lip
Similarly, blockages in the sinuses will block the flow of air from outside to inside the body. Sinuses may be impaired by:
  • Nasal congestion from a sinus infection , cold, or allergies
  • Structural defects of the sinuses or their drainage system
Pulmonary barotrauma may be more likely in those with damage from previous or current lung conditions.Other factors that may affect the ability for air spaces in the body to work properly include:

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