Ear barotrauma is a painful or uncomfortable sensation in the ear due to pressure differences between the middle ear and the outside air or water. The pain can be acute, lasting only a few minutes, or it can be chronic, lasting a long time and possibly leading to complications. Acute cases are generally harmless and clear up without treatment. Chronic cases require medical intervention. Ear barotrauma causes and treatments vary in relation to the severity of the symptoms. Symptoms for both can include hearing loss, dizziness, a feeling of fullness in the ear, and overall discomfort. Serious cases involve more pain and pressure, fluid or blood drainage, increased hearing loss, and eardrum injury.
The descent of the scuba diver into the ocean or lake causes an imbalance of pressure between the middle ear and the water. This affects the eardrum or tympanic membrane. Fast descent does not give the middle ear time to adjust to the pressure and may result in damage to the eardrum. Scuba divers must descend and return to the surface slowly.
Taking off and landing in an airplane causes air pressure changes in the cabin, and can lead to discomfort and pain as the middle ear works to accommodate. Most people who have flown in airplanes have felt at least mild ear barotrauma. The symptoms can often be mitigated by chewing gum, yawning, sucking on hard candies, and repeated swallowing. This minor annoyance should go away when the air pressure stabilizes. Driving up and down a mountain can have the same effect.
The eustachian tube runs from the back of the mouth to the ear. This tube helps maintain pressure when there are changes outside the ear. If it becomes blocked, it may cause pain and discomfort in the middle ear. A doctor will ask when the pain started and try to find out if it is related to pressure changes or an infection. He will examine the outer ear and the eardrum for damage. Removing the obstruction will allow air to move in and out freely.
An ear infection can create an imbalance in pressure. Fluid behind the eardrum can block the pressure regulation of the middle ear, causing severe pain. Children are particularly affected by this. They may have hearing loss due to the accumulated fluid, and it may become chronic as long as the fluid remains untreated. Medically draining the fluid will relieve this pressure.
If nasal congestion, upper respiratory infection, or allergies are blocking the eustachian tubes, taking over-the-counter medications may relieve the pressure in the ear by drying up secretions. Saline nasal spray can help open nasal passages and allow air to flow into and out of the middle ear, relieving pressure. It is important not to use ear drops, which may cause further complications. If the pain or discomfort continues, see a doctor.
Any diver who ascends or descends quickly and begins to feel discomfort in the ear should immediately stop and wait. This will give the ear a chance to stabilize the pressure differences between the water and the middle ear. Continue when the pain recedes. If it doesn't, slowly come to the surface.
Surgery is the last resort for treating ear barotrauma and generally only used to resolve an underlying cause. A ruptured eardrum may need surgery but more often heals itself. The physician may choose to place small, cylindrical ear tubes through the eardrum to alleviate chronic middle ear pressure, especially in children; this can treat hearing loss due to chronic infections and fluid accumulations in the middle ear.
As a preventative measure, stay away from cleaning the ears with After surgery, avoid infection by keeping the ear clean and free from contamination while it heals. Antibiotics can clear up an infection if one occurs. For mild cases, the discomfort may stop within minutes, and you should generally take no treatment. Simple techniques like opening the mouth wide and yawning to open the eustachian tubes are useful.
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