Ear Barotrauma

Arrow signifying high pressure pushing against eardrum on external ear side and arrow signifying low pressure pushing against eardrum on middle ear side. Labels include: Eardrum, Middle ear.

Ear barotrauma is a problem of the middle ear and eardrum. It occurs when unequal pressures form inside the middle ear and outside the eardrum. This often happens with altitude or pressure changes such as during an airplane flight or scuba diving. It can also occur after a blow to the head. If you already have congestion from a cold or allergies, barotrauma is more likely to occur.

Symptoms include pressure and pain in the ears. You may feel dizzy. Your ears may feel plugged. You may also have short-term hearing loss. In severe cases, the eardrum may rupture. This can lead to bleeding and infection.

Often, self-care is all that is needed to relieve symptoms. Even a ruptured eardrum will most likely heal on its own. If it does not, surgery may be needed to repair it. In this case, you’ll be referred to a specialist for further care.

Home care

You may use over-the-counter pain medicine unless another pain medicine was prescribed. You may use over-the-counter oral or nasal decongestants and antihistamines to help ease congestion, unless you were given prescriptions for such medicines. To help prevent or treat an ear infection, you may be prescribed antibiotics. Be sure to take all medicines as directed. Also be sure to complete the medicines.

Prevention

  • Each ear has an eustachian tube, which connects the middle ear to the back of the throat. Certain self-care steps can help keep the eustachian tubes open and relieve pressure in the middle ear. These steps include:

    • Yawning

    • Swallowing often

    • Sucking on candy

    • Chewing gum

    • Performing the Valsalva maneuver. To do this, take a deep breath and hold it. Pinch your nostrils closed. Then blow gently against your closed nostrils until you feel a “popping” sensation in your ears.

  • Nose, sinus, or ear congestion makes barotrauma more likely. Use caution if you have a cold, infection, or allergies. If you have any of these and need to fly, take an antihistamine and decongestant 1 to 2 hours before flying.

  • When flying, don't sleep during the descent. Use the self-care steps listed above to help open the eustachian tubes.

  • When scuba diving, descend and ascend slowly. Diving when you have any sinus, ear, or nasal congestion is not recommended.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Fever of 100.4°F (38°C) or higher , or as directed by your healthcare provider

  • Increasing pain or ringing in your ears

  • Hearing loss that lasts longer than 2 days

  • Fluid or blood draining from the ear

  • Dizziness

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