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:
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:
The imbalance of pressure causes the air inside your body to shrink or swell. This is what can cause pain and damage.
Activities that can expose someone to significant pressure changes include:
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:
Similarly, blockages in the sinuses will block the flow of air from outside to inside the body. Sinuses may be impaired by:
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:
Symptoms will depend on what areas are affected.
Ear barotrauma may cause:
Sinus barotrauma may cause:
Pulmonary barotrauma may cause:
Your doctor will ask about your symptoms and medical history. A physical exam will be done to look for irritation or tissue damage. Barotrauma may be suspected based on your recent activities, such as air travel or scuba diving.
Ear structures will be visually examined
Suspected pulmonary barotrauma may be evaluated with:
Pulmonary barotrauma is serious and needs immediate medical attention. Treatment will depend on the specific lung problem that is present.
The following measures can also prevent barotrauma. Treatment options include the following:
Pressure can be relieved with self-care and medications.
To relieve the pressure in the eustachian tube, you can:
It is important to relieve nasal congestion and open your eustachian tube. Medications to relieve ear and sinus pressure include:
Pain relievers can be used if ear or sinus pressure is causing pain. Antibiotics may be used if a bacterial infection is present or possible.
Emergency medical care may include:
Surgery may be necessary to relieve the pressure if your eustachian tube does not open with other treatments. Your doctor will make a small cut in your eardrum to equalize the air pressure. Any fluid blocking the tube may also be removed.
Oxygen should be given immediately for pulmonary barotrauma. The oxygen can be given through a mask over the face or by a tube under the nose.
To help reduce your chances of barotrauma during:
To help your baby through pressure changes, give your baby a pacifier or bottle during landing and take off.
American Academy of Otolaryngology—Head and Neck Surgery
Divers Alert Network
Canadian Society of Otolaryngology—Head and Neck Surgery
Barotrauma. American Hearing Research Foundation website. Available at: http://american-hearing.org/disorders/barotrauma. Updated October 2012. Accessed December 21, 2017.
Barotrauma. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries-poisoning/injury-during-diving-or-work-in-compressed-air/barotrauma. Updated July 2017. Accessed December 21, 2017.
Brandt MT. Oral and maxillofacial aspects of diving medicine. Military Medicine. 2004;169(2):137-141.
Diving precautions and prevention of diving injuries. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries-poisoning/injury-during-diving-or-work-in-compressed-air/diving-precautions-and-prevention-of-diving-injuries. Updated July 2017. Accessed December 21, 2017.
Ears and altitude. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/ears-and-altitude. Accessed December 21, 2017.
Newton HB. Neurologic complications of scuba diving. Am Fam Physician. 2001;63(11):2211-2218.
Last reviewed November 2018 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 12/20/2014